| NPI | 1902271539 |
|---|---|
| Doing Business As | JACOBSEN PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MATTHEW VAUGHN JACOBSEN Pediatric Dentist 801-589-3150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: UT 83203479923) |
| Enumeration Date | 2015-12-08 |
| Last Update Date | 2015-12-08 |