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Dr. Theodore Edward Jacobson, DMD
Student in an Organized Health Care Education/Training Program in Newark, New Jersey
NPI 1417649088

Theodore Edward Jacobson is a Student in an Organized Health Care Education/Training Program based in Newark, NJ. Theodore Edward Jacobson practices in Newark, NJ and has the professional credentials of DMD. The NPI Number for Theodore Edward Jacobson is 1417649088 and holds a License No. (New Jersey).

The current practice location address for Theodore Edward Jacobson is 110 Bergen St, Newark, NJ and can be reached out via phone at 650-740-1026.

Location: 110 Bergen St, Newark, NJ, 07103-2495
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1417649088
Provider Name
Theodore Edward Jacobson
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
110 Bergen St, Newark, NJ, 07103-2495
Phone Number
650-740-1026
Fax Number
Provider Enumeration Date
05/23/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
110 Bergen St
City
Newark
State
New Jersey
Zip
07103-2495
Phone Number
650-740-1026
Fax Number
person
Provider Business Mailing Address Details
Address
110 Bergen St
City
Newark
State
New Jersey
Zip
07103-2495
Phone Number
650-740-1026
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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