Individual
JORDAN CHRISTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3500 GASTON AVE, DALLAS, TX 75246
(214) 820-2361
Mailing address
PO BOX 555191, CAMP PENDLETON, CA 92055-5191
(760) 725-5178
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
107164
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
30363
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/14/2014
Last updated
08/21/2022
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