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General NPI Number Information
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NPI Number | 1649157439
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Entity Type | Organization
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Legal Business Name | JORDAN M. CALDWELL DDS LLC
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Dates
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Enumeration Date | 08/21/2025
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 2018 E MADISON AVE
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City | BASTROP
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State | LA
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Zip | 71220-4035
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Country | US
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Telephone | 318-814-8136
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Fax |
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Provider Business Mailing Address
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Address Line | 416 COPPER FLDS
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City | STERLINGTON
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State | LA
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Zip | 71280-3534
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Country | US
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Telephone | 318-450-2941
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. JORDAN CALDWELL
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Credential | DDS
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Telephone | 318-450-2941
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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