Individual
DR. JORDAN MITCHELL SPAVOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
260 SOUTH ST, LAWRENCE, MI 49064-9325
(269) 621-3143
Mailing address
8022 LAKE WOOD DR, PORTAGE, MI 49002-5565
(313) 571-4008
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901601054
MI
Other
Enumeration date
07/29/2021
Last updated
07/29/2021
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