# JOHN T GORDON D.D.S., P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033657325
- **Authorized official:** JOHN GORDON D.D.S. (PRESIDENT)
- **Authorized official phone:** (631) 581-3500

## Contact information

- **Practice address:** 111 CARLETON AVE, STE 1, ISLIP TERRACE, NY 11752-2236
- **Practice address phone:** (631) 581-3500
- **Mailing address:** 111 CARLETON AVE, STE 1, ISLIP TERRACE, NY 11752-2236

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 044635 | NY | Yes |

## Other

- **Enumeration date:** 02/07/2017
- **Last updated:** 02/07/2017