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Individual

DR. JOHN RAY GORDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
2655 CAMINO DEL RIO N STE 140, SAN DIEGO, CA 92108-1633
(619) 282-7088
(619) 282-6290
Mailing address
3814 CORRAL CANYON RD, BONITA, CA 91902-2806
(619) 267-1662

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
4183
LA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
51878
CA

Other

Enumeration date
08/18/2005
Last updated
11/23/2010
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