| Petra Gordon Dmd Pllc | |
|
609 Lamar Ave Brooksville FL 34601-3211 | |
| (352) 796-2034 | |
| (888) 581-9789 |
| Full Name | Petra Gordon Dmd Pllc |
|---|---|
| Speciality | Dentist |
| Location | 609 Lamar Ave, Brooksville, Florida |
| Authorized Official Name and Position | Petra G Lee (OWNER) |
| Authorized Official Contact | 3527962034 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Petra Gordon Dmd Pllc 609 Lamar Ave Brooksville FL 34601-3211 Ph: (352) 796-2034 | Petra Gordon Dmd Pllc 609 Lamar Ave Brooksville FL 34601-3211 Ph: (352) 796-2034 |
| NPI Number | 1154708097 |
|---|---|
| Provider Enumeration Date | 04/29/2015 |
| Last Update Date | 04/29/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154708097 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN 17627 (Florida) | Primary |
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