Jackson, Lue Dee
Jackson, Lue Dee is an sole proprietor health care provider with primary practice located at 386 A-B Warren Street , Roxbury MA 02119. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Jackson, Lue Dee can be contacted via phone (800) 676-2750.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 15374 | Massachusetts |
Profile Details
| NPI number | 1568623841 |
|---|---|
| LBN Legal business name | Jackson, Lue Dee |
| Credentials | DMD, MD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 19th, 2008 |
| Last updated | Jun 19th, 2008 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568623841 | NPPES |
| Massachusetts | MEDICAID | 0262331 |
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