Organization
JACQUELINE BENNETT DDS PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACQUELINE RAE BENNETT DDS (OWNER)
(520) 886-3303
Entity
Organization
Contact information
Practice address
1200 N EL DORADO PL, SUITE C320, TUCSON, AZ 85715-4637
(520) 886-3303
(520) 886-3305
Mailing address
4121 N LARREA LN, TUCSON, AZ 85750-2438
(520) 886-3303
(520) 886-3305
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4891
AZ
Other
Enumeration date
06/06/2007
Last updated
08/22/2020
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