Individual
MR. JORDAN KANE ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
146 HIGH ST UNIT 1, IPSWICH, MA 01938-1212
(978) 276-9990
Mailing address
95 HOPKINS ST APT 502, WAKEFIELD, MA 01880-2269
(617) 470-5696
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN10000243
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
MA
Other
Enumeration date
04/12/2024
Last updated
06/12/2024
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