Organization
HEALTHY KIDS FIRST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY L JORDAN D.D.S (DENTIST)
(317) 254-5601
Entity
Organization
Contact information
Practice address
5963 CALAIS CT, INDIANAPOLIS, IN 46220-6004
(317) 562-1260
(317) 562-1356
Mailing address
5963 CALAIS CT, INDIANAPOLIS, IN 46220-6004
(317) 562-1260
(317) 562-1356
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12008913
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200246650
PROVIDER NUMBER
IN
Enumeration date
07/22/2008
Last updated
07/22/2008
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