Individual
JORDAN JON ANNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15255 WATERTOWN PLANK RD STE 100, ELM GROVE, WI 53122-2338
(262) 784-7770
Mailing address
15255 WATERTOWN PLANK RD STE 100, ELM GROVE, WI 53122-2338
(262) 784-7770
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1002421-15
WI
Other
Enumeration date
08/24/2020
Last updated
12/06/2023
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