Organization
PROGRESSIVE DENTAL CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY M GORDON DDS (VICE PRESIDENT)
(717) 637-0202
Entity
Organization
Contact information
Practice address
250 FAME AVE, SUITE 206, HANOVER, PA 17331-1587
(717) 637-0202
(717) 637-5855
Mailing address
PO BOX 471, HANOVER, PA 17331-0471
(717) 637-0202
(717) 637-5855
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
24985
PA
1223G0001X
General Practice Dentistry
36615
PA
1223P0221X
Pediatric Dentistry
28116
PA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
22314
PA
Other
Enumeration date
02/01/2007
Last updated
02/04/2011
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