NPI 1043323504
Wanda Kay Jackson, RDH
Practice location
- Address
- 510 E Stoner Ave #160, Shreveport, LA 71101-4243
- Phone
- (318) 221-8411
- Fax
- (318) 841-4795
Registered specialties
Dental Hygienist
Primary
Registry record
- NPI
- 1043323504
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 17 Aug 2006
- Record last updated
- 8 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.