Provider Demographics
NPI:1942382395
Name:JACOBSON, ARNOLD SCOTT (DMD)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:SCOTT
Last Name:JACOBSON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 S MERAMEC AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105
Mailing Address - Country:US
Mailing Address - Phone:314-726-1644
Mailing Address - Fax:314-726-2286
Practice Address - Street 1:225 S MERAMEC AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63105
Practice Address - Country:US
Practice Address - Phone:314-726-1644
Practice Address - Fax:314-726-2286
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MODEO125791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice