Individual
CHRISTOPHER MICHAEL GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
840 TIOGUE AVE, COVENTRY, RI 02816-2900
(401) 828-1171
Mailing address
115 PLEASANT ST, NORTH KINGSTOWN, RI 02852-5047
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
DEN03596
RI
1223P0221X
Pediatric Dentistry
Primary
DN1859344
MA
Other
Enumeration date
03/27/2020
Last updated
06/20/2022
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