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Individual

DR. JENNIFER L GORDON-MALONEY

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
300 STONECREST BOULEVARD, SUITE 385, SMYRNA, TN 37167-1200
(615) 223-1200
(615) 223-1090
Mailing address
300 STONECREST BOULEVARD, SUITE 385, SMYRNA, TN 37167-1200
(615) 223-1200
(615) 223-1090

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS0000007428
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000232437
UNITED HEALTHCARE ID#
TN
01
0015738
DORAL DENTAL OF TN ID#
TN
01
272484
CIGNA DMO DENTAL ID #
TN
05
3728862
TN
01
4095527
BC/BS MEDICAL/DENTAL ID#
TN
Enumeration date
08/26/2005
Last updated
07/09/2007
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