Individual
DR. JORDAN HIGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
929 S UTAH AVE, IDAHO FALLS, ID 83402-3322
(208) 529-2199
Mailing address
370 N STATE ST, BOX 683, SHELLEY, ID 83274-1141
(208) 360-8540
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D-4205
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/12/2007
Last updated
05/22/2009
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