Individual
JORDAN BROUGHTON BOONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
140 VETERANS BLVD, DENHAM SPRINGS, LA 70726-5100
(225) 800-4495
Mailing address
29138 S REDWOOD DR, DENHAM SPRINGS, LA 70726-3146
(601) 620-9111
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7390
LA
Other
Enumeration date
12/05/2022
Last updated
01/05/2024
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