Individual
MELODY LYN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDHAP
Contact information
Practice address
630 BROADVIEW ST, SPRING VALLEY, CA 91977-5522
(619) 246-3491
(619) 434-6288
Mailing address
630 BROADVIEW ST, SPRING VALLEY, CA 91977-5522
(619) 246-3491
(619) 434-6288
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Enumeration date
05/08/2007
Last updated
07/08/2007
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