Individual
JORDAN RUSSELL WACHTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8535 E HARTFORD DR STE 202, SCOTTSDALE, AZ 85255-5444
(480) 515-1000
Mailing address
2817 SE 16TH AVE, PORTLAND, OR 97202-2269
(602) 369-9845
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D012276
AZ
Other
Enumeration date
05/08/2024
Last updated
07/24/2024
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