| NPI | 1104977222 |
|---|---|
| Former Legal Business Name | JAKUBAS DENTAL |
| Entity Type | Organization |
| Authorized Contact | JENNA LYNN SWENSON Owner 320-761-2259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MN 10142) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-12-31 |