Individual
DR. DENNIS JORDAN WIDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4860 CHERRY AVE, SAN JOSE, CA 95118-3716
(408) 265-4480
(408) 997-2946
Mailing address
4860 CHERRY AVE, SAN JOSE, CA 95118-3716
(408) 265-4480
(408) 997-2946
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
18666
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D18666
DENTICAL
CA
Enumeration date
03/29/2007
Last updated
07/08/2007
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