Blain Jacobson, DMD Valid NPI
Individual provider · Orthodontics and Dentofacial Orthopedics Dentistry · Granite Bay, CA
- NPI
- 1700049749
- Type
- Individual (Type 1)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223X0400X
- License number
- 56390 (CA)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2008-07-09
- Last updated
- 2008-12-18
Practice location
6910 Douglas Blvd Ste A
Granite Bay, CA 95746-6276
(916) 813-5363