Individual
DR. DONALD R GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3 PINE TREE DR, BROOMALL, PA 19008-2740
(484) 485-7156
Mailing address
3 PINE TREE DR, BROOMALL, PA 19008-2740
(484) 485-7156
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN5723
FL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS017817-L
PA
207L00000X
Anesthesiology Physician
DA017817A
PA
Other
Enumeration date
05/10/2006
Last updated
11/20/2009
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