WANDA KAY JACKSON

SHREVEPORT, LA
NPI1043323504
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy124Q00000X Dental Hygienist
(Licence: LA  376)
Enumeration Date2006-08-17
Last Update Date2007-07-08
Business Address
Mrs. WANDA KAY JACKSON RDH
510 E STONER AVE #160
SHREVEPORT, LA 71101-4243
Phone number: 318-221-8411
Mailing Address
Mrs. WANDA KAY JACKSON RDH
510 E STONER AVE #160
SHREVEPORT, LA 71101-4243
Phone number: 318-221-8411
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