Individual
DR. BASIL GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2503 EASTBLUFF DR, SUITE 104, NEWPORT BEACH, CA 92660-3505
(949) 640-7922
Mailing address
2503 EASTBLUFF DR, SUITE 104, NEWPORT BEACH, CA 92660-3505
(949) 640-7922
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
40599
CA
Other
Enumeration date
02/11/2008
Last updated
02/11/2008
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