Jacobson, Dale Everett
Jacobson, Dale Everett is an individual health care provider with primary practice located at 1411 W Saint Germain St Suite #103, Saint Cloud MN 56301-4121. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Jacobson, Dale Everett can be contacted via phone (320) 253-2121.Contact Information
Primary practice address
1411 W Saint Germain St Suite #103
Saint Cloud MN 56301-4121
Phone: (320) 253-2121
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 7680 | Minnesota |
Profile Details
| NPI number | 1356416135 |
|---|---|
| LBN Legal business name | Jacobson, Dale Everett |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 21st, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356416135 | NPPES |
| Minnesota | Other | 7680 | DENTAL LICENSE NUMBER |
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