Individual
AUSTIN JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2455 MEDICAL CENTER PKWY, SELMA, AL 36701-7756
(334) 872-0486
Mailing address
223 HOOPER DR, SELMA, AL 36701-6524
(251) 362-4490
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-0007050-C1
AL
Other
Enumeration date
06/09/2022
Last updated
06/09/2022
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