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General NPI Number Information
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NPI Number | 1386924785
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Entity Type | Individual
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Provider Name | DAVID SCOTT JACOBSON DDS
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Gender | Male
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Dates
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Enumeration Date | 08/17/2011
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Last Update Date | 11/28/2022
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Provider Practice Location Address
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Address Line | 62 E THRIVE DR
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City | SARATOGA SPRINGS
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State | UT
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Zip | 84045-5558
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Country | US
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Telephone | 385-200-0613
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Fax |
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Provider Business Mailing Address
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Address Line | 276 E IRONWOOD DR
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City | SARATOGA SPRINGS
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State | UT
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Zip | 84045-5036
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Country | US
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Telephone | 702-290-2054
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 10687964-9923
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License Number State | UT
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