Organization
JORDAN FAMILY DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATIE MARIE FERRAZ-SOUZA DDS (DENTIST / OWNER)
(952) 492-2021
Entity
Organization
Contact information
Practice address
301 EL DORADO DRIVE, JORDAN, MN 55352
(952) 492-2021
(952) 492-6505
Mailing address
301 EL DORADO DRIVE, JORDAN, MN 55352
(952) 492-2021
(952) 492-6505
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
05/26/2023
Last updated
04/10/2026
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