Provider Demographics
NPI:1295466050
Name:CRONIN, JORDAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:
Last Name:CRONIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JORDAN
Other - Middle Name:
Other - Last Name:VERPLANK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2608A EGRET WAY
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-1910
Mailing Address - Country:US
Mailing Address - Phone:402-202-6898
Mailing Address - Fax:
Practice Address - Street 1:415 S CONOCOCHEAGUE ST STE 100
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:MD
Practice Address - Zip Code:21795-1565
Practice Address - Country:US
Practice Address - Phone:301-223-7440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-22
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17484122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist