Individual
DR. JACQUELINE R BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2300 N CRAYCROFT RD STE 2, TUCSON, AZ 85712-2808
(520) 886-3303
(520) 886-2236
Mailing address
2300 N CRAYCROFT RD STE 2, TUCSON, AZ 85712-2808
(520) 886-3303
(520) 886-2236
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4891
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
524795
—
AZ
Enumeration date
01/17/2007
Last updated
08/02/2023
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