Individual
JORDAN POND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
9221 E BASELINE RD, MESA, AZ 85209-8310
(480) 357-7759
Mailing address
3787 E CULLUMBER ST, GILBERT, AZ 85234-4318
(480) 294-5686
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D008952
AZ
Other
Enumeration date
05/19/2014
Last updated
01/13/2015
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