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Individual

DR. SHARON SNELL JORDAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.M.D.

Contact information

Practice address
2614 CHEROKEE AVE, MACON, GA 31204-3924
(478) 743-3583
(478) 743-8847
Mailing address
2614 CHEROKEE AVE, MACON, GA 31204-3924
(678) 230-6929
(478) 743-3583

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN009686
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00254878C
GA
Enumeration date
04/07/2011
Last updated
01/25/2015
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