Individual
JORDAN GORM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2525 28TH ST UNIT 140, BOULDER, CO 80301-1255
(303) 443-0070
Mailing address
1675 UPHAM ST APT 7, LAKEWOOD, CO 80214-5270
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
906364
CO
Other
Enumeration date
05/05/2014
Last updated
05/05/2014
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