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Organization
THE PREVENTIVE DENTISTRY CNTR PC
Active
Organization
THE PREVENTIVE DENTISTRY CNTR PC
Active
Parent organization
THE PREVENTIVE DENTISTRY CENTER PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE PREVENTIVE DENTISTRY CENTER PC
Authorized official
DR. JEFFREY G GORDON DDS (PRESIDENT)
(773) 445-3337
Entity
Organization
Contact information
Practice address
8244 S KEDZIE AVE, CHICAGO, IL 60652-3329
(773) 445-3337
(773) 445-3340
Mailing address
PO BOX 29052, CHICAGO, IL 60629-0052
(773) 445-3337
(773) 445-3340
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019023383
IL
Other
Enumeration date
06/16/2008
Last updated
02/18/2022
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