Individual
DAVID DOUGLAS GARDNER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
2 SOUTH MAIN ST, ANDOVER, NY 14806
(607) 478-8426
Mailing address
9 MALIN LN, PENFIELD, NY 14526-2232
(585) 864-9704
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
041343
NY
Other
Enumeration date
12/22/2005
Last updated
07/08/2007
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