Individual
DR. KOBIE CHARLES GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
205 REVERE BEACH PKWY UNIT 630, REVERE, MA 02151-5491
(703) 655-0464
Mailing address
205 REVERE BEACH PKWY UNIT 630, REVERE, MA 02151-5491
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN03465
RI
Other
Enumeration date
11/08/2019
Last updated
11/08/2019
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