Organization
JASON R. GORDON D.D.S. P. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON R GORDON (DENTIST/OWNER)
(347) 281-9444
Entity
Organization
Contact information
Practice address
724 PELHAM PKWY S, BRONX, NY 10462-1029
(347) 281-9444
Mailing address
724 PELHAM PKWY S, BRONX, NY 10462-1029
(347) 281-9444
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0528121
NY
1223G0001X
General Practice Dentistry
—
—
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
09/14/2009
Last updated
09/14/2009
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