MRS. Wanda Kay Jackson, RDH

NPI #1043323504 in Shreveport, Louisiana

Provider Information

NPI Number: 1043323504
Entity Type: Individual
Name: MRS. Wanda Kay Jackson, RDH
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dental Hygienist
Credential: RDH
Enumeration Date: Aug 17, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 510 E STONER AVE
Address 2: #160
City: Shreveport
State: Louisiana
ZIP Code: 71101-4243
Phone: (318) 221-8411

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Hygienist	124Q00000X	Primary

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