Individual
JORDAN MATTHEW GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5 COLLEGE AVE, WINDSOR, NY 13865-4109
(607) 655-2141
(607) 655-3388
Mailing address
5 COLLEGE AVE, PO BOX 347, WINDSOR, NY 13865-4109
(607) 655-2141
(607) 655-3388
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
055268
NY
Other
Enumeration date
09/22/2010
Last updated
09/22/2010
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