Individual
GORDON AVERILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
2435 PLANTATION CENTER DR STE 100, MATTHEWS, NC 28105-5148
(704) 847-7426
Mailing address
2435 PLANTATION CENTER DR STE 100, MATTHEWS, NC 28105-5148
(704) 847-7426
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12810
NC
122300000X
Dentist
DDS101899
CA
122300000X
Dentist
DN1856859
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043695513
—
MA
Enumeration date
07/27/2015
Last updated
01/13/2023
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