Individual
BROOKE TOTTY JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1206 HIGHWAY 78 E, JASPER, AL 35501-3939
(205) 221-9190
Mailing address
4250 MARDEN WAY, VESTAVIA, AL 35242-2211
(205) 515-3404
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6565-C1
AL
Other
Enumeration date
08/31/2018
Last updated
08/31/2018
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