DR. Jacob Vaughn Liljenquist, DMD

NPI #1508172107 in Pocatello, Idaho

Provider Information

NPI Number: 1508172107
Entity Type: Individual
Name: DR. Jacob Vaughn Liljenquist, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DMD
Enumeration Date: Aug 20, 2010
Last Updated: May 17, 2019

Practice Location

Address: 1000 N 8TH AVE
City: Pocatello
State: Idaho
ZIP Code: 83201-5757
Phone: (208) 232-3368

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary
Dentist	122300000X
Dentist - Dental Public Health — Dental Public Health	1223D0001X

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