Organization
CHRISTA L JACKSON DENTAL HYGIENIST, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTA LYNN JACKSON RDHAP (PRESIDENT)
(818) 269-8898
Entity
Organization
Contact information
Practice address
4508 SAINT CLAIR AVE, STUDIO CITY, CA 91604-1209
(818) 269-8898
(818) 506-2595
Mailing address
4508 SAINT CLAIR AVE, STUDIO CITY, CA 91604-1209
(818) 269-8898
(818) 506-2595
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128592243
—
CA
Enumeration date
06/10/2021
Last updated
08/27/2021
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