Provider Demographics
NPI:1205582624
Name:GORDON & SCHELLER, DDS, PLLC
Entity type:Organization
Organization Name:GORDON & SCHELLER, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-277-2531
Mailing Address - Street 1:2708 NC-127 SOUTH
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602
Mailing Address - Country:US
Mailing Address - Phone:828-672-1000
Mailing Address - Fax:878-672-1030
Practice Address - Street 1:2708 NC-127 SOUTH
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602
Practice Address - Country:US
Practice Address - Phone:828-672-1000
Practice Address - Fax:878-672-1030
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GORDON & SCHELLER, DDS, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty