Organization
KEVIN R JORDAN DMD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN R JORDAN DMD (OWNER)
(606) 286-4121
Entity
Organization
Contact information
Practice address
154 SCOTT ST, OLIVE HILL, KY 41164
(606) 286-4121
Mailing address
PO BOX 562, OLIVE HILL, KY 41164
(606) 286-4121
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6868
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60068681
—
KY
Enumeration date
04/11/2007
Last updated
09/03/2014
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