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Contact Information

MELISSA D JACKSON, DMD
EDGEWOOD DENTAL
7 MUNICIPAL WAY
EDGEWOOD, NM87015
 Phone: 505-281-3406
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for MELISSA D JACKSON · (Female)

NPI # 1871930099
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 05/29/2013
Last updated 10/17/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • NM License # DD3828
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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