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Individual

JORDAN MICHAEL JENKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
1941 W BOULEVARD, KOKOMO, IN 46902-6027
(765) 453-6200
Mailing address
20251 JAMES RD, NOBLESVILLE, IN 46062-9048
(812) 607-0597

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12012319A
IN
1223G0001X
General Practice Dentistry
DN 21241
FL

Other

Enumeration date
06/06/2015
Last updated
04/02/2021
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