Individual
DR. DANIEL RICHARD JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
NAVY MEDICINE SUPPORT COMMAND ATTN: MEDICAL STAFF SVCS, BLDG H 2005 KNIGHT LANE, JACKSONVILLE, FL 32212-0140
(725) 760-3213
Mailing address
26450 RIDGE VALE DR, SANTA CLARITA, CA 91321-2222
(661) 361-6986
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN.00205296
CO
Other
Enumeration date
08/11/2022
Last updated
08/11/2022
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