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Organization
DOUGLAS DENTAL CORPORATION
Active
Organization
DOUGLAS DENTAL CORPORATION
Active
Other names
Noho Modern Dentistry Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN CHELSEY DOUGLAS DDS (OWNER)
(818) 616-7817
Entity
Organization
Contact information
Practice address
10930 MAGNOLIA BLVD, NORTH HOLLYWOOD, CA 91601-3903
(818) 616-7817
(818) 638-9608
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
(714) 845-8890
(303) 952-0892
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/14/2022
Last updated
10/14/2022
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