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1063011799
JORDAN CHELSEY DOUGLAS
CORONA, CA
NPI
1063011799
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: CA 105748)
Enumeration Date
2020-10-23
Last Update Date
2020-10-23
Business Address
JORDAN CHELSEY DOUGLAS
460 N MCKINLEY ST
CORONA, CA 92879-3405
Phone number: 951-531-9693
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Mailing Address
JORDAN CHELSEY DOUGLAS
770 S GRAND AVE APT 5066
LOS ANGELES, CA 90017-3949
Phone number: 678-749-9540
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