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Individual

RICHARD C.K. JORDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS PHD

Contact information

Practice address
513 PARNASSUS AVE, SAN FRANCISCO, CA 94143-2205
(415) 476-4868
Mailing address
PO BOX 10076, VAN NUYS, CA 91410-0076
(805) 578-8300
(805) 578-8950

Taxonomy

Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
58144
CA
1223P0106X
Oral and Maxillofacial Pathology Dentistry
DE60086482
WA

Other

Enumeration date
04/04/2006
Last updated
11/23/2009
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