# JORDAN LEDGER, DDS, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Chicago Oral Surgery & Implant Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841740149
- **Authorized official:** JORDAN LEDGER D.D.S. (OWNER/ORAL SURGEON)
- **Authorized official phone:** (319) 321-1394

## Contact information

- **Practice address:** 1229 W WASHINGTON BLVD, SUITE 220, CHICAGO, IL 60607-2132
- **Practice address phone:** (312) 620-1926
- **Mailing address:** 1229 W WASHINGTON BLVD, SUITE 220, CHICAGO, IL 60607-2132
- **Mailing address phone:** (312) 620-1926

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 019028719 | IL | Yes |

## Other

- **Enumeration date:** 10/11/2016
- **Last updated:** 10/11/2016