Individual
LANCE D GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
335 E 88TH ST APT 1A, NEW YORK, NY 10128-4951
(617) 459-2159
Mailing address
335 EAST 88TH ST APT 1A, NEW YORK, NY 10128
(617) 459-2159
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
055113
NY
Other
Enumeration date
08/25/2010
Last updated
05/03/2011
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