| Jacobsen Dental | |
|
103 1st Ave Sw Ephrata WA 98823-1842 | |
| (509) 754-3262 | |
| (509) 754-4975 |
| Full Name | Jacobsen Dental |
|---|---|
| Speciality | Dentist |
| Location | 103 1st Ave Sw, Ephrata, Washington |
| Authorized Official Name and Position | Brian James Jacobsen (OWNER) |
| Authorized Official Contact | 5097543262 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacobsen Dental 103 1st Ave Sw Ephrata WA 98823-1842 Ph: (509) 754-3262 | Jacobsen Dental 103 1st Ave Sw Ephrata WA 98823-1842 Ph: (509) 754-3262 |
| NPI Number | 1942758180 |
|---|---|
| Provider Enumeration Date | 09/16/2016 |
| Last Update Date | 09/16/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942758180 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 60128176 (Washington) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Secondary |
Ephrata Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 21 C St Sw, Ephrata, WA 98823 Phone: 509-754-4226 |