Individual
CYNTHIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS MS
Contact information
Practice address
1620 ALPINE BLVD STE 212, ALPINE, CA 91901-1105
(619) 445-8883
Mailing address
573 ANDERSON RD, ALPINE, CA 91901-1504
(619) 249-0818
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
37034
CA
Other
Enumeration date
04/15/2020
Last updated
04/15/2020
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