Organization
JORDAN D HAEDT DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORDAN DANELL HAEDT DDS (DENTIST OWNER)
(785) 742-2165
Entity
Organization
Contact information
Practice address
514 DELAWARE ST, HIAWATHA, KS 66434-2118
(785) 742-2165
Mailing address
514 DELAWARE ST, HIAWATHA, KS 66434-2118
(785) 742-2165
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
61189
KS
Other
Enumeration date
11/20/2017
Last updated
06/16/2018
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