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DR. PHILLIP BRANDON GORDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
123 HILL POND LN, STATESBORO, GA 30458-0872
(912) 402-5437
Mailing address
2128 GARY ST, AUGUSTA, GA 30904-3573
(478) 501-3199

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN016102
GA
390200000X
Student in an Organized Health Care Education/Training Program
DN016102
GA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
02/21/2020
Last updated
07/30/2024
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