Individual
DR. GLEN GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1 HAMPTON RD, EXETER, NH 03833-4848
(603) 772-7874
Mailing address
454 LINCOLN AVE, PORTSMOUTH, NH 03801-5123
(603) 431-8920
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2083
NH
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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