NPI 1851581078
Desirae Jackson, CDA
Practice location
- Address
- VA Wny Healthcare System 3495 Bailey Ave, Buffalo, NY 14215-1311
- Phone
- (716) 862-8738
- Mailing address
- 62 Croy Ave, Buffalo, NY 14215-1311
Registered specialties
Dental Assistant
Primary
Registry record
- NPI
- 1851581078
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 25 Jul 2007
- Record last updated
- 25 Jul 2007
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.