Individual
MILLARD DENNIS JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
17563 GREENFIELD, DETROIT, MI 48235
(313) 272-0118
(313) 272-0488
Mailing address
17563 GREENFIELD, DETROIT, MI 48235
(313) 272-0118
(313) 272-0488
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901012336
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4053791
—
MI
Enumeration date
03/23/2007
Last updated
07/08/2007
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