Organization
PERIODONTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE D GORDON DMD (PRESIDENT)
(207) 772-7459
Entity
Organization
Contact information
Practice address
612 BRIGHTON AVE, PORTLAND, ME 04102-2359
(207) 772-7459
(207) 874-6460
Mailing address
612 BRIGHTON AVE, PORTLAND, ME 04102-2359
(207) 772-7459
(207) 874-6460
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
2204
ME
Other
Enumeration date
05/01/2007
Last updated
08/22/2020
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