Jordan Chelsey Douglas

NPI #1063011799 in Corona, California

Provider Information

NPI Number: 1063011799
Entity Type: Individual
Name: Jordan Chelsey Douglas
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Enumeration Date: Oct 23, 2020
Last Updated: Oct 23, 2020

Practice Location

Address: 460 N MCKINLEY ST
City: Corona
State: California
ZIP Code: 92879-3405
Phone: (951) 531-9693

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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