Individual
JORDAN ENDRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
150 NE KENNETH FORD DR, ROSEBURG, OR 97470-1042
(541) 672-9596
Mailing address
1116 SE TERRACE DR, ROSEBURG, OR 97470-4360
(480) 286-1188
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10432
OR
390200000X
Student in an Organized Health Care Education/Training Program
RR60578878
WA
Other
Enumeration date
02/12/2016
Last updated
04/10/2023
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