Individual
JARED WILLIAM GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2036 S MILLER LN STE B, CATOOSA, OK 74015-1539
(918) 937-7660
Mailing address
910 E GARY PL, BROKEN ARROW, OK 74012-7784
(801) 874-9593
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7746
OK
Other
Enumeration date
05/08/2023
Last updated
05/08/2023
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