Jordan, Clint R

Jordan, Clint R is an sole proprietor health care provider with primary practice located at 130 West Old Highway 2 , Merna NE 68856. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Jordan, Clint R can be contacted via phone (308) 643-2255.

Contact Information

Primary practice address
130 West Old Highway 2 Merna NE 68856
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 6837 Nebraska

Profile Details

NPI number 1215260286
LBN Legal business name Jordan, Clint R
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 9th, 2009
Last updated Sep 22nd, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215260286 NPPES
Nebraska MEDICAID 10026061400

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