Individual
DR. STEPHANIE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2854 NORTHWESTERN PIKE, CAPON BRIDGE, WV 26711-9052
(304) 856-3200
Mailing address
1385 SANDERS LN, OAKLAND, MD 21550-7435
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4498
WV
1223G0001X
General Practice Dentistry
16578
MD
Other
Enumeration date
07/23/2018
Last updated
01/21/2022
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