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Organization
JOURDAN FAMILY DENTISTRY
Active
Organization
JOURDAN FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS B JOURDAN D.D.S. (DENTIST)
(918) 256-6831
Entity
Organization
Contact information
Practice address
120A W DELAWARE AVE, VINITA, OK 74301-4224
(918) 256-6831
Mailing address
120A W DELAWARE AVE, VINITA, OK 74301-4224
(918) 256-6831
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5381
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
263477085001
BLUE CROSS BLUE SHIELD
OK
01
—
803040C
UNITED CONCORDIA
OK
01
—
OK5381
DELTA DENTAL
OK
Enumeration date
05/01/2008
Last updated
05/01/2008
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