Individual
JORDAN MILES CHRISTENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
29 BEE STREET, CHARLESTON, SC 29403
(435) 979-0461
Mailing address
1402 CAMP RD APT 5G, CHARLESTON, SC 29412-3711
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
10398139-9921
UT
1223G0001X
General Practice Dentistry
Primary
9206
SC
Other
Enumeration date
01/31/2018
Last updated
08/14/2018
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