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1952688293
DANIEL R JACOBSEN
BLOOMINGTON, IL
NPI
1952688293
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: IL 019.028635)
Enumeration Date
2011-11-15
Last Update Date
2011-11-15
Business Address
Dr. DANIEL R JACOBSEN D.M.D.
3220 GERIG DR
BLOOMINGTON, IL 61704-6394
Phone number: 309-662-7722
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Mailing Address
Dr. DANIEL R JACOBSEN D.M.D.
3220 GERIG DR
BLOOMINGTON, IL 61704-6394
Phone number:
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