Individual
JORDAN WALTER HOLMGREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
123 BRYAN ST, KENANSVILLE, NC 28349-8799
(910) 275-1880
Mailing address
7408 DARIUS DR, WILMINGTON, NC 28411-6211
(651) 983-2799
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12506
NC
Other
Enumeration date
10/05/2021
Last updated
10/05/2021
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