Individual
KATIE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
18190 RAINBOW DR, LATHRUP VILLAGE, MI 48076-4518
(313) 505-6665
(248) 864-8648
Mailing address
18190 RAINBOW DR, LATHRUP VILLAGE, MI 48076-4518
(313) 505-6665
(248) 864-8648
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902012177
MI
Other
Enumeration date
10/24/2018
Last updated
10/24/2018
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