Individual
JORDAN MARC SIMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4168 BAKER ST NE, COVINGTON, GA 30014-1404
(770) 787-2230
Mailing address
3235 THE COMMONS DR, CUMMING, GA 30041-9740
(954) 668-8203
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN122464
GA
1223G0001X
General Practice Dentistry
DN122464.
GA
Other
Enumeration date
08/30/2021
Last updated
08/30/2021
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