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General NPI Number Information
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NPI Number | 1336951292
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Entity Type | Organization
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Legal Business Name | JORDAN S. CHRISTENSEN D.D.S. ORAL AND FACIAL SURGERY DENTAL GROUP INC
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 3144 EL CAMINO REAL STE 101
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City | CARLSBAD
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State | CA
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Zip | 92008-2194
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Country | US
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Telephone | 801-865-1009
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Fax |
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Provider Business Mailing Address
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Address Line | 3965 PACKARD LN
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City | CARLSBAD
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State | CA
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Zip | 92008-3651
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Country | US
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Telephone | 801-865-1009
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JORDAN CHRISTENSEN
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Credential | DDS
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Telephone | 801-865-1009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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License Number |
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License Number State |
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