DR. Jordan Spencer, DDS

NPI #1649495458 in Charleston, Illinois

Provider Information

NPI Number: 1649495458
Entity Type: Individual
Name: DR. Jordan Spencer, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Apr 16, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 826 W LINCOLN AVE
City: Charleston
State: Illinois
ZIP Code: 61920-2464
Phone: (217) 345-1315

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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