Individual
DR. THOMAS DAVID JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
346 FORT ZUMWALT SQ, O FALLON, MO 63366-3065
(636) 978-6400
(636) 980-1125
Mailing address
346 FORT ZUMWALT SQ, O FALLON, MO 63366-3065
(636) 978-6400
(636) 980-1125
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15009
MO
Other
Enumeration date
02/25/2013
Last updated
02/25/2013
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