Dames, Jacalyn Renee

Dames, Jacalyn Renee is an individual health care provider with primary practice located at 4092 Crest Dr , House Springs MO 63051-1570. She recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Orthodontics and Dentofacial Orthopedics. Dental Providers / Orthodontics and Dentofacial Orthopedics is her primary health care specialty. Dames, Jacalyn Renee can be contacted via phone (636) 575-8436.

Contact Information

Primary practice address
4092 Crest Dr House Springs MO 63051-1570
Phone: (636) 575-8436
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X X183076005 Missouri
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X X183076005 Missouri

Profile Details

NPI number 1902213465
LBN Legal business name Dames, Jacalyn Renee
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2014
Last updated Jul 16th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902213465 NPPES
Missouri MEDICAID 37424356

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