Individual
DR. GORDON MARVIN RICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
5190 GOVERNOR DR, SUITE 106, SAN DIEGO, CA 92122-2847
(858) 784-0600
(858) 784-0604
Mailing address
5190 GOVERNOR DR, SUITE 106, SAN DIEGO, CA 92122-2847
(858) 784-0600
(858) 784-0604
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
20041
CA
Other
Enumeration date
04/02/2007
Last updated
03/14/2008
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