Organization
GORDON ORTHODONTICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM MICHAEL GORDON DMD (ORTHODONTIST)
(401) 828-1171
Entity
Organization
Contact information
Practice address
1171 MAIN STREET, HOPE VALLEY, RI 02832
(401) 828-1171
(401) 828-4704
Mailing address
840 TIOGUE AVE, COVENTRY, RI 02816-5914
(401) 828-1171
(401) 828-4704
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
842039
UNITED CONCORDIA
RI
05
—
WG00555
—
RI
Enumeration date
02/12/2010
Last updated
01/31/2011
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