Individual
MATHEW CHARLES GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D. D.D.S.
Contact information
Practice address
235 E HILDEBRAND AVE, SAN ANTONIO, TX 78212-2430
(210) 824-4501
(210) 824-0125
Mailing address
430 DEVINE RD, SAN ANTONIO, TX 78212-2527
(210) 824-4501
(210) 824-0125
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
16834
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
K6594
TX
Other
Enumeration date
12/06/2006
Last updated
07/09/2007
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