Individual
DR. JASON R GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
724 PELHAM PKWY S, BRONX, NY 10462-1029
(917) 658-1996
Mailing address
724 PELHAM PKWY S, BRONX, NY 10462-1029
(917) 658-1996
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
052812-1
NY
Other
Enumeration date
06/01/2007
Last updated
07/29/2009
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