Organization
COLUMBUS ENDODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORDON C JACOBS DDS, MSD (DENTIST)
(812) 361-4051
Entity
Organization
Contact information
Practice address
3200 MIDDLE RD, COLUMBUS, IN 47203-4426
(812) 372-3636
Mailing address
5990 HOLLOW CT, BARGERSVILLE, IN 46106-8503
(812) 361-4051
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12012180A
DENTAL LICENSE
IN
Enumeration date
12/01/2021
Last updated
03/07/2023
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