Individual
LISA JACOBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
106 NW 9TH AVE, MULBERRY, FL 33860-2922
(863) 425-6200
Mailing address
47 5TH ST NW, WINTER HAVEN, FL 33881-4672
(863) 268-7850
(863) 268-7899
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH17486
FL
Other
Enumeration date
09/26/2018
Last updated
09/26/2018
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