Individual
DR. BENJAMIN SLADER JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4420 DIXIE HWY STE 110, LOUISVILLE, KY 40216-2986
(502) 305-2534
Mailing address
75 STANFORD ST APT A, SOUTH PORTLAND, ME 04106-1548
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11056
KY
1223G0001X
General Practice Dentistry
DEN5005
ME
390200000X
Student in an Organized Health Care Education/Training Program
—
ME
Other
Enumeration date
08/23/2022
Last updated
09/13/2024
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