Jackson, Desirae

Jackson, Desirae is an individual health care provider with primary practice located at Va Wny Healthcare System 3495 Bailey Ave, Buffalo NY 14215-1311. She recently has only one registered license in Dental Providers / Dental Assistant, which is considered as her primary health care specialty. Jackson, Desirae can be contacted via phone (716) 862-8738.

Contact Information

Primary practice address
Va Wny Healthcare System 3495 Bailey Ave Buffalo NY 14215-1311
Phone: (716) 862-8738
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Assistant 126800000X

Profile Details

NPI number 1851581078
LBN Legal business name Jackson, Desirae
Credentials Certified Dental Assistant (CDA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2007
Last updated Jul 25th, 2007 - about 18 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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