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Individual
DR. PAUL E GORDON
Active
Individual
DR. PAUL E GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, M.D.
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
8424
MA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
246483
MA
Other
Enumeration date
07/14/2006
Last updated
05/09/2019
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