Individual
JOHN COURTNEY GORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
617 N RIVER DR, MARION, IN 46952-2648
(765) 662-0018
Mailing address
617 N RIVER DR, MARION, IN 46952-2648
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12008906A
IN
Other
Enumeration date
07/05/2007
Last updated
07/08/2007
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