Organization
BENNETT JACOBY DDS MS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENNETT JACOBY DDS (OWNER)
(808) 329-7246
Entity
Organization
Contact information
Practice address
2978 HALEKO RD, STE A, LIHUE, HI 96766-1379
(808) 960-5991
Mailing address
PO BOX 75407294, SIOUX FALLS, SD 57186-2119
(808) 960-5991
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
DT2112
HI
Other
Enumeration date
04/24/2009
Last updated
11/07/2016
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