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General NPI Number Information
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NPI Number | 1376628289
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Entity Type | Organization
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Legal Business Name | DR W SCOTT JORDAN DDS PA
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 334 N MAIN ST
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City | RUTHERFORDTON
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State | NC
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Zip | 28139-2506
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Country | US
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Telephone | 828-287-4381
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Fax | 828-286-0531
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Provider Business Mailing Address
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Address Line | 334 N MAIN ST
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City | RUTHERFORDTON
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State | NC
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Zip | 28139-2506
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Country | US
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Telephone | 828-287-4381
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Fax | 828-286-0531
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM SCOTT JORDAN
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Credential | DDS
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Telephone | 828-287-4381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4780
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License Number State | NC
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