Individual
DR. JORDAN ALEXANDER REZNIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
236 PERIMETER CENTER PKWY NE STE C-30, ATLANTA, GA 30346-1402
(404) 625-3009
Mailing address
191 STEWART DR, ATLANTA, GA 30342-1907
(404) 406-1251
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D015858
GA
390200000X
Student in an Organized Health Care Education/Training Program
DN015858
GA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/13/2019
Last updated
08/30/2020
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