Individual
LUKE JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2217 OLD JEANERETTE RD, NEW IBERIA, LA 70563-8687
(337) 321-5651
Mailing address
3601 KALISTE SALOOM RD UNIT 107, LAFAYETTE, LA 70508-7633
(337) 356-6845
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6491
LA
Other
Enumeration date
06/16/2014
Last updated
06/16/2014
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