Individual
DR. JACQUELINE MICHELLE HETTERICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
155 LAWN AVE, BUFFALO, NY 14207-1816
(717) 875-2904
Mailing address
155 LAWN AVE, BUFFALO, NY 14207-1816
(716) 875-2904
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
059742
NY
Other
Enumeration date
07/02/2018
Last updated
07/02/2018
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