Individual
GUADALUPE VIRGINIA JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1391 TULIP CIR S, BEAUMONT, CA 92223-8458
(951) 977-0668
Mailing address
1391 TULIP CIR S, BEAUMONT, CA 92223-8458
(951) 977-0668
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
1074
CA
Other
Enumeration date
06/04/2024
Last updated
06/04/2024
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