Individual
DIVINIA JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
639 HEMPSTEAD TPKE, FRANKLIN SQUARE, NY 11010-4334
(516) 565-6565
(516) 565-3391
Mailing address
639 HEMPSTEAD TPKE, FRANKLIN SQUARE, NY 11010-4334
(516) 565-6565
(516) 565-3391
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0398881
NY
Other
Enumeration date
02/18/2014
Last updated
02/18/2014
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