Individual
DR. BRENDA JO GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
141 W JACKSON BLVD, #3632, CHICAGO, IL 60604-2929
(312) 939-2400
Mailing address
141 W JACKSON BLVD, #3632, CHICAGO, IL 60604-2929
(312) 939-2400
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019020338
IL
1223G0001X
General Practice Dentistry
30018904
OH
1223G0001X
General Practice Dentistry
32427
CA
Other
Enumeration date
09/26/2006
Last updated
09/12/2008
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