# MICHAEL ANTHONY GORDON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1851407027
- **Gender:** Man
- **Credential:** D.D.S.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12009120 | IN | Yes |

## Other

- **Enumeration date:** 08/21/2006
- **Last updated:** 12/04/2020