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Organization
MELINDA P. GORDON D.M.D. A DENTAL CORPORATION
Active
Organization
MELINDA P. GORDON D.M.D. A DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELINDA PIEGA GORDON D.M.D. (PRESIDENT)
(818) 705-2931
Entity
Organization
Contact information
Practice address
16935 VANOWEN ST. SUITE A, LAKE BALBOA, CA 91406
(818) 705-2931
(818) 344-9565
Mailing address
16935 VANOWEN ST. SUITE A, LAKE BALBOA, CA 91406
(818) 705-2931
(818) 344-9565
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
32605
CA
Other
Enumeration date
10/03/2006
Last updated
08/22/2020
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