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Individual

DR. ELVA VILLA JORDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
7002 MCPHERSON RD, SUITE 104, LAREDO, TX 78041-6418
(956) 725-5035
(956) 717-4106
Mailing address
7002 MCPHERSON RD, SUITE 104, LAREDO, TX 78041-6418
(956) 725-5035
(956) 717-4106

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
25077
TX
1223P0221X
Pediatric Dentistry
Primary
25077
TX
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/29/2009
Last updated
06/12/2012
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