Provider Demographics
NPI:1518138205
Name:JACOBSON, ALBERT PAGE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:PAGE
Last Name:JACOBSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7575 W UNIVERSITY AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-7600
Mailing Address - Country:US
Mailing Address - Phone:352-331-5132
Mailing Address - Fax:352-332-5472
Practice Address - Street 1:7575 W UNIVERSITY AVE
Practice Address - Street 2:SUITE E
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-7600
Practice Address - Country:US
Practice Address - Phone:352-331-5132
Practice Address - Fax:352-332-5472
Is Sole Proprietor?:No
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN51551223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics