Individual
JORDAN BLOCHWITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1560 CARLEMONT DR, CRYSTAL LAKE, IL 60014-2740
(815) 893-6345
Mailing address
720 N BRIAR HILL LN APT 3, ADDISON, IL 60101-2235
(608) 635-5614
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.034245
IL
Other
Enumeration date
06/08/2023
Last updated
06/08/2023
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