Individual
JORDAN DIAMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2204 E 29TH AVE STE 104, SPOKANE, WA 99203
(509) 321-1404
Mailing address
2204 E 29TH AVE STE 104, SPOKANE, WA 99203-3961
(509) 321-1404
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DE60824201
WA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
DE60824201
WA
Other
Enumeration date
04/25/2014
Last updated
10/18/2024
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