Organization
JEREMIAH D GORDON, DMD, PA
Active
Other names
Gordon Dental Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMIAH D GORDON DMD (DENTIS/OWNER)
(904) 460-0999
Entity
Organization
Contact information
Practice address
53 WILLOW DR, ST AUGUSTINE, FL 32080-5936
(904) 471-5336
Mailing address
135 JENKINS ST, SUITE 105A, ST AUGUSTINE, FL 32086-5175
(904) 460-0999
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16348
FL
Other
Enumeration date
01/22/2009
Last updated
01/22/2009
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