Provider Demographics
NPI:1417997917
Name:DAVID P. GORDON DMDPC
Entity Type:Organization
Organization Name:DAVID P. GORDON DMDPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:DMDPC
Authorized Official - Phone:603-894-5494
Mailing Address - Street 1:8 STILES RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-2847
Mailing Address - Country:US
Mailing Address - Phone:603-894-5494
Mailing Address - Fax:603-894-7331
Practice Address - Street 1:8 STILES RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2847
Practice Address - Country:US
Practice Address - Phone:603-894-5494
Practice Address - Fax:603-894-7331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty