Individual
ANTOINETTE ALICIA GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
109 GRAND AVE, BROOKLYN, NY 11205-2567
(718) 622-9223
Mailing address
109 GRAND AVE, BROOKLYN, NY 11205-2567
(718) 622-9223
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
023891-1
NY
Other
Enumeration date
03/31/2009
Last updated
03/31/2009
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