Individual
JESSICA YVETTE HACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, DMD
Contact information
Practice address
9921 CARMEL MOUNTAIN RD, #186, SAN DIEGO, CA 92129-2813
(310) 709-2418
Mailing address
9921 CARMEL MOUNTAIN RD, #186, SAN DIEGO, CA 92129-2813
(310) 709-2418
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
OMS58
CA
Other
Enumeration date
10/27/2006
Last updated
01/17/2012
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