Woodson, Lesa Rae
Woodson, Lesa Rae is an sole proprietor health care provider with primary practice located at 2400 Maritime Dr , Elk Grove CA 95758-3660. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Woodson, Lesa Rae can be contacted via phone (916) 686-8914.Contact Information
Primary practice address
2400 Maritime Dr
Elk Grove CA 95758-3660
Phone: (916) 686-8914
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 59194 | California |
Profile Details
| NPI number | 1063549228 |
|---|---|
| LBN Legal business name | Woodson, Lesa Rae |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 27th, 2007 |
| Last updated | Oct 27th, 2023 - about 2 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 | 1063549228 | NPPES |
| Louisiana | MEDICAID | 1856088 |
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