Individual
DR. GORDON MATHEW CALLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
820 S DAMEN AVE, JESSE BROWN VAMC DENTAL SERVICE, CHICAGO, IL 60612-3728
(312) 569-6669
(312) 569-8089
Mailing address
438 S ASHLAND AVE, LA GRANGE, IL 60525-6310
(708) 508-0437
(312) 569-8089
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
—
IL
Other
Enumeration date
09/26/2006
Last updated
07/08/2007
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