Individual
DR. JORDAN TAYLOR GABRIELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2529
(173) 833-3112
Mailing address
1001 S GEORGE ST, YORK, PA 17403-3676
(717) 851-2655
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
018.002180
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/05/2019
Last updated
06/14/2021
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