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Individual

DR. DOUGLASS K GORDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
140 SHAWNEE ST, GREENVILLE, OH 45331-2529
(937) 548-0755
(937) 548-9787
Mailing address
140 SHAWNEE ST, GREENVILLE, OH 45331-2529
(937) 548-0755
(937) 548-9787

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
30019792
OH

Other

Enumeration date
10/06/2006
Last updated
07/08/2007
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