| Gordon Dental Associates | |
|
53 Willow Dr St Augustine FL 32080-5936 | |
| (904) 471-5336 | |
| Not Available |
| Full Name | Gordon Dental Associates |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 53 Willow Dr, St Augustine, Florida |
| Authorized Official Name and Position | Jeremiah D Gordon (DENTIS/OWNER) |
| Authorized Official Contact | 9044600999 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gordon Dental Associates 135 Jenkins St Suite 105a St Augustine FL 32086-5175 Ph: (904) 460-0999 | Gordon Dental Associates 53 Willow Dr St Augustine FL 32080-5936 Ph: (904) 471-5336 |
| NPI Number | 1376781864 |
|---|---|
| Provider Enumeration Date | 01/22/2009 |
| Last Update Date | 01/22/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376781864 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 16348 (Florida) | Primary |
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