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Individual
DR. DONALD R GORDON
Active
Individual
DR. DONALD R GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN5723
FL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS017817-L
PA
207L00000X
Anesthesiology Physician
DA017817A
PA
Other
Enumeration date
05/10/2006
Last updated
11/20/2009
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