Individual
DR. TODD F JORGENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.S.
Contact information
Practice address
3048 E BASELINE RD, SUITE 112, MESA, AZ 85204-7286
(480) 558-4500
Mailing address
3048 E BASELINE RD, SUITE 112, MESA, AZ 85204-7286
(480) 558-4500
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
5804
AZ
Other
Enumeration date
01/18/2007
Last updated
07/08/2007
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