Individual
ANDREA L JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.D.T.
Contact information
Practice address
895 7TH ST E, SAINT PAUL, MN 55106
(651) 602-7500
Mailing address
366 HALL AVE, SAINT PAUL, MN 55107-1132
(651) 698-3185
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
H5837
MN
125J00000X
Dental Therapist
Primary
DT28
MN
Other
Enumeration date
08/22/2013
Last updated
06/21/2018
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