Individual
DR. PATRICIA LYNN GORDON-WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
2643 RANDLEMAN RD, GREENSBORO, NC 27406-5153
(336) 544-2758
Mailing address
302 N EUGENE ST APT 311, GREENSBORO, NC 27401-3398
(601) 212-5917
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN014937
GA
1223G0001X
General Practice Dentistry
DEN1000945
DC
1223P0221X
Pediatric Dentistry
Primary
12416
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/13/2007
Last updated
11/22/2021
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