Individual
DR. JASON M GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1963 S 1200 E STE 103, SALT LAKE CITY, UT 84105-3523
(801) 466-1212
Mailing address
4577 S 4000 W STE B, WEST VALLEY, UT 84120-6222
(801) 895-2788
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11313905-9922
UT
Other
Enumeration date
06/06/2019
Last updated
06/09/2020
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