Individual
JORDAN NICOLE BREEDING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10000 BROWNSBORO RD, LOUISVILLE, KY 40241-3900
(502) 890-7760
Mailing address
2603 DELOR AVE, LOUISVILLE, KY 40217-2301
(812) 599-7412
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10619
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730766213
—
KY
Enumeration date
03/29/2021
Last updated
06/23/2022
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