Individual
JORDAN J TICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MHA
Contact information
Practice address
2101 CHARLOTTE ST STE 350, KANSAS CITY, MO 64108-2764
(816) 404-0550
Mailing address
500 E 8TH ST APT 700, KANSAS CITY, MO 64106-1604
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2025021171
MO
Other
Enumeration date
06/09/2025
Last updated
06/09/2025
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