| Melinda P. Gordon D.m.d. A Dental Corporation | |
|
16935 Vanowen St. Suite A Lake Balboa CA 91406 | |
| (818) 705-2931 | |
| (818) 344-9565 |
| Full Name | Melinda P. Gordon D.m.d. A Dental Corporation |
|---|---|
| Speciality | Dentist |
| Location | 16935 Vanowen St. Suite A, Lake Balboa, California |
| Authorized Official Name and Position | Melinda Piega Gordon (PRESIDENT) |
| Authorized Official Contact | 8187052931 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Melinda P. Gordon D.m.d. A Dental Corporation 16935 Vanowen St. Suite A Lake Balboa CA 91406 Ph: (818) 705-2931 | Melinda P. Gordon D.m.d. A Dental Corporation 16935 Vanowen St. Suite A Lake Balboa CA 91406 Ph: (818) 705-2931 |
| NPI Number | 1053405118 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053405118 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 32605 (California) | Primary |
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