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JASON BRENT JORDAN DMD

>> Dentist >> Dental Providers

Registrant NPI Number: 1720180813

Individual Registrant:
 JASON BRENT JORDAN DMD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
279 5TH AVE  ASHVILLE, AL 35953 US
Tel: 205-594-5044  Fax: 205-594-5044

Contact information for business:
PO BOX 129  ASHVILLE, AL 35953 US
Tel: 205-594-5044  Fax: 205-594-5388

Registration Information:
NPI: 1720180813
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
AL5192

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS AL - Page 1

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