Individual
DR. JACOB JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6936 PINE ARBOR DR S STE 210, COTTAGE GROVE, MN 55016-4672
(651) 769-1000
Mailing address
965 IOWA AVE W, SAINT PAUL, MN 55117-3358
(651) 343-9612
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D14958
MN
Other
Enumeration date
07/05/2023
Last updated
07/05/2023
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