Individual
MERSEDES S. JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
KENNER ARMY HEALTH CLINIC, 700 24TH STREET, FORT GREGG-ADAMS, VA 23801
(804) 734-5365
Mailing address
KENNER ARMY HEALTH CENTER, 700 24TH STREET, FORT GREGG-ADAMS, VA 23801
(804) 734-5365
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401416895
VA
Other
Enumeration date
06/25/2018
Last updated
11/07/2024
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