| Jacobsen Pediatric Dentistry | |
|
4019 W 12600 S Ste 200 Riverton UT 84096-7406 | |
| (801) 302-7938 | |
| Not Available |
| Full Name | Jacobsen Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 4019 W 12600 S Ste 200, Riverton, Utah |
| Authorized Official Name and Position | Matthew Vaughn Jacobsen (PEDIATRIC DENTIST) |
| Authorized Official Contact | 8015893150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacobsen Pediatric Dentistry 4019 W 12600 S Ste 200 Riverton UT 84096-7406 Ph: (801) 302-7938 | Jacobsen Pediatric Dentistry 4019 W 12600 S Ste 200 Riverton UT 84096-7406 Ph: (801) 302-7938 |
| NPI Number | 1902271539 |
|---|---|
| Provider Enumeration Date | 12/08/2015 |
| Last Update Date | 12/08/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902271539 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 83203479923 (Utah) | Primary |
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