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NANCY WISE JORDAN DDS
>> Dentist >> Dental ProvidersRegistrant NPI Number: 1942217799
Individual Registrant: NANCY WISE JORDAN DDS
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
108 6TH ST GROTTOES, VA 24441 US
Tel: 540-249-4242 Fax: 540-249-4732
Tel: 540-249-4242 Fax: 540-249-4732
Contact information for business:
PO BOX 308 108 6TH ST GROTTOES, VA 24441 US
Tel: 540-249-4242 Fax: 540-249-4732
Tel: 540-249-4242 Fax: 540-249-4732
Registration Information:
NPI: 1942217799
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 122300000X | Dental Providers Dentist | VA | 0401006821 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
