Provider Demographics
NPI:1811903289
Name:GORDON, DAVID J II (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:GORDON
Suffix:II
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 WEST AVE
Mailing Address - Street 2:SUITE 1312
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-3840
Mailing Address - Country:US
Mailing Address - Phone:512-708-8900
Mailing Address - Fax:512-494-8088
Practice Address - Street 1:300 WEST AVE
Practice Address - Street 2:SUITE 1312
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-3840
Practice Address - Country:US
Practice Address - Phone:512-708-8900
Practice Address - Fax:512-494-8088
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX177991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice