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General NPI Number Information
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NPI Number | 1699797662
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Entity Type | Organization
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Legal Business Name | JON JACOBSON, II, DDS, PC
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1016 N MICHIGAN AVE
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City | SAGINAW
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State | MI
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Zip | 48602-4325
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Country | US
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Telephone | 989-754-7500
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Fax | 989-754-7780
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Provider Business Mailing Address
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Address Line | 1016 N MICHIGAN AVE
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City | SAGINAW
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State | MI
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Zip | 48602-4325
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Country | US
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Telephone | 989-754-7500
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Fax | 989-754-7780
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JON MATTHEW JACOBSON
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Credential | D.D.S.
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Telephone | 989-754-7500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901009423
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License Number State | MI
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