Individual
JACQUELINE D CUNNINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
3460 LIBERTY RD S, SALEM, OR 97302-4607
(503) 371-2424
Mailing address
1310 WALLACE RD NW, APT 14, SALEM, OR 97304-3078
(503) 991-4406
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
DH61023
OH
124Q00000X
Dental Hygienist
Primary
H6478
OR
Other
Enumeration date
07/23/2013
Last updated
07/23/2013
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