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1265442107
JACKY CLAY STANDLEE
JEFFERSON CITY, MO
NPI
1265442107
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: MO 014960)
Enumeration Date
2006-08-09
Last Update Date
2007-07-08
Business Address
Dr. JACKY CLAY STANDLEE D.D.S.
WESTSIDE DENTAL 994 DIAMOND RIDGE STE 202
JEFFERSON CITY, MO 65109
Phone number: 573-893-4402
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Mailing Address
Dr. JACKY CLAY STANDLEE D.D.S.
5405 WARDSVILLE RD
JEFFERSON CITY, MO 65101-8744
Phone number: 573-634-7313
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