| NPI | 1922380310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY JACOBSON Owner 916-877-7450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2024-03-06 |