Individual
DR. JONATHAN DALES GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
5425 VERNA BLVD, JACKSONVILLE, FL 32205-4762
(904) 826-7923
Mailing address
5425 VERNA BLVD, JACKSONVILLE, FL 32205-4762
(904) 826-7923
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18388
FL
Other
Enumeration date
11/21/2009
Last updated
12/14/2009
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