Provider Demographics
NPI:1639442304
Name:FINGERMAN, GORDON MARTIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:GORDON
Middle Name:MARTIN
Last Name:FINGERMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18411 CLARK ST STE 200
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3540
Mailing Address - Country:US
Mailing Address - Phone:818-705-3232
Mailing Address - Fax:818-705-3260
Practice Address - Street 1:18411 CLARK ST STE 200
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3540
Practice Address - Country:US
Practice Address - Phone:818-705-3232
Practice Address - Fax:818-705-3260
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA285461223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics