NPI 1205045796
Stephanie Andreya Jackson, RDH
Practice location
- Address
- 801 Crestview Ave, Provo, UT 84604-4777
- Phone
- (801) 222-9354
Registered specialties (3)
Dental Hygienist
Primary
Dental Hygienist
Dental Hygienist
Registry record
- NPI
- 1205045796
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 21 May 2007
- 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.