Individual provider · Type 1 NPI

Jacob Vaughn Liljenquist, DMD

General Practice Dentistry · Pocatello, ID

NPI number 1508172107 Active

Practice location

1000 N 8th Ave
Pocatello, ID 83201-5757

Call (208) 232-3368 Map

Fax (208) 776-5016

Mailing address

9435 Castle Oaks Dr
Fountain, CO 80817-4517

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry Primary 1223G0001X7754866-9921 (UT)
Dentist 122300000X7754866-9921 (UT)
Dentist 122300000XDE60162914 (WA)
Public Health Dentistry 1223D0001XD4811 (ID)

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

16 other providers at this address

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About NPI 1508172107

Jacob Vaughn Liljenquist, DMD's National Provider Identifier is 1508172107, issued on Aug 20, 2010. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Pocatello, ID. The record was last updated on May 17, 2019.