Individual
DR. JUSTIN RICHARD JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1667 COCHRANE CIR BLDG 7495, FORT CARSON, CO 80913-4603
(719) 526-5537
Mailing address
1667 COCHRANE CIR BLDG 7495, FORT CARSON, CO 80913-4603
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13486282-9921
UT
Other
Enumeration date
07/13/2023
Last updated
07/13/2023
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