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Individual

HARRISON GORDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
2133 PEPPERRELL ST BLDG 3352, 2133 PEPPERRELL STREET, BUILDING 3352, JBSA LACKLAND, TX 78236-5313
(210) 292-6258
Mailing address
2133 PEPPERRELL ST BLDG 3352, 59 DG AF POSTGRADUATE DENTAL SCHOOL, JBSA LACKLAND, TX 78236-5313
(210) 292-6258

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS039972
PA

Other

Enumeration date
06/11/2014
Last updated
06/14/2016
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