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Contact Information

JACKY C STANDLEE, DDS
WESTSIDE DENTAL 994 DIAMOND RIDGE
STE 202
JEFFERSON CITY, MO65109
 Phone: 573-893-4402
 Fax: 573-632-4398
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for JACKY C STANDLEE · (Male)

NPI Number 1265442107
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 08/09/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • MO License # 014960
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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