Individual
JORDAN CIMILLUCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8901 WISCONSIN AVENUE, WALTER REED MILITARY MEDICAL CENTER, BETHESDA, MD 20889
(301) 295-4341
(301) 400-1085
Mailing address
8901 WISCONSIN AVENUE, WALTER REED MILITARY MEDICAL CENTER, BETHESDA, MD 20889
(301) 295-4341
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
00205129
CO
171000000X
Military Health Care Provider
Primary
00205129
CO
Other
Enumeration date
03/07/2022
Last updated
08/21/2023
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