Individual
DR. GORDON LADD DOUGLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3960 EL CAMINO AVE, SUITE 1, SACRAMENTO, CA 95821-6534
(916) 483-4964
(916) 483-6380
Mailing address
3960 EL CAMINO AVE, SUITE 1, SACRAMENTO, CA 95821-6534
(916) 483-4964
(916) 483-6380
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
21792
CA
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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