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General NPI Number Information
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NPI Number | 1730829326
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Entity Type | Organization
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Legal Business Name | JORDAN A. TORTORICH DDS PLLC
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Dates
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Enumeration Date | 03/31/2022
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Last Update Date | 03/31/2022
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Provider Practice Location Address
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Address Line | 4909 HIGHWAY 5 N STE 1200
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City | BRYANT
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State | AR
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Zip | 72022-7066
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Country | US
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Telephone | 501-481-8178
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Fax |
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Provider Business Mailing Address
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Address Line | 4909 HIGHWAY 5 N STE 1200
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City | BRYANT
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State | AR
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Zip | 72022-7066
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Country | US
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Telephone | 501-481-8178
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Fax |
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Authorized Official
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Title or Position | DDS/OWNER
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Name | DR. JORDAN TORTORICH
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Credential | DDS
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Telephone | 501-481-8178
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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