Individual
JORDYN PAIGE DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
3123 MILLER AVE, CROSSVILLE, TN 38555-6119
(931) 484-3664
Mailing address
118 CHARLESTON LN APT 106, CROSSVILLE, TN 38555-0642
(208) 881-4391
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
10918
TN
Other
Enumeration date
11/04/2024
Last updated
11/04/2024
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