JORDAN BROADWATER

KINGSPORT, TN
NPI1164317020
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy122300000X Dentist
(Licence: TN  12846)
Enumeration Date2025-06-11
Last Update Date2025-06-11
Business Address
Dr. JORDAN BROADWATER DDS
2701 BLOOMINGDALE RD
KINGSPORT, TN 37660-1854
Phone number: 423-288-8566
Mailing Address
Dr. JORDAN BROADWATER DDS
1024 FORREST RIDGE DR
KINGSPORT, TN 37660-6628
Phone number: 423-306-5052