Individual
RUTH JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
577 STERNBERG AVE, FORT EUSTIS, VA 23604-1526
(757) 314-7825
Mailing address
1988 VAN VOORHIS ST UNIT A, FORT EUSTIS, VA 23604-1409
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
04/27/2021
Last updated
04/27/2021
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