Organization · NPI-2
Christa L Jackson Dental Hygienist, INC.
Dental Hygienist · Studio City, CA
NPI number1447827167
StatusActive
Last updated in NPPESAug 27, 2021
Details
- NPI
- 1447827167
- Entity type
- Organization (NPI-2)
- Legal business name
- Christa L Jackson Dental Hygienist, INC.
- Organization subpart
- No
- Enumeration date
- Jun 10, 2021
- Certification date
- Aug 26, 2021
- Last updated
- Aug 27, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 124Q00000X | Dental Hygienist | – | – | Yes |
Practice location
4508 Saint Clair AveStudio City, CA 91604-1209
Phone 818-269-8898 · Fax 818-506-2595
Mailing address
4508 Saint Clair AveStudio City, CA 91604-1209
Phone 818-269-8898 · Fax 818-506-2595
Authorized official
Christa Lynn Jackson
President
8182698898
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