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Individual

DR. GORDON RICHARD WHITE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
2821 N BALLAS RD, SUITE 260, SAINT LOUIS, MO 63131-2321
(314) 567-4850
(314) 567-5877
Mailing address
2821 N BALLAS RD, SUITE 260, SAINT LOUIS, MO 63131-2321
(314) 567-4850
(314) 567-5877

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
11033
MO

Other

Enumeration date
11/08/2006
Last updated
07/08/2007
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