Individual
MIKHAIL GORDEEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
450 MAIN STREET, METUCHEN, NJ 08840
(732) 452-0222
(732) 452-0220
Mailing address
450 MAIN STREET, METUCHEN, NJ 08840
(732) 452-0222
(732) 452-0220
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DI20451
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7956100
—
NJ
Enumeration date
10/25/2006
Last updated
07/08/2007
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