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Individual

DR. ASIA GORDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
63 MAIN ST, BROCKTON, MA 02301
(508) 559-6699
Mailing address
350 N CLARK ST FL 6, CHICAGO, IL 60654-4712

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1857801
MA

Other

Enumeration date
10/29/2017
Last updated
06/05/2018
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