Individual
DR. JACOB ROSKELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
3089 D ST, KANEOHE BAY, HI 96863
(808) 257-3100
Mailing address
BLDG 3089 D ST, KANEOHE BAY, HI 96863
(808) 257-3100
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DT2380
HI
Other
Enumeration date
07/01/2009
Last updated
07/01/2009
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