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Individual

STEPHANIE SPURLOCK GORDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1245 NW 119TH ST, MIAMI, FL 33167-3231
(305) 685-7863
Mailing address
282 NE 54TH ST APT 1, MIAMI, FL 33137-2822
(786) 344-6583

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
18410
FL
124Q00000X
Dental Hygienist
Primary
DH 18410
FL

Other

Enumeration date
05/29/2009
Last updated
05/29/2009
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