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1124199468
JOE GORDON
LAKE FOREST, IL
NPI
1124199468
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223P0221X Dentist, Pediatric Dentistry
(Licence: IL 019.024258)
Enumeration Date
2006-11-10
Last Update Date
2007-07-08
Business Address
Dr. JOE GORDON D.D.S.
514 N WESTERN AVE
LAKE FOREST, IL 60045-1989
Phone number: 847-482-1900
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Mailing Address
Dr. JOE GORDON D.D.S.
514 N WESTERN AVE
LAKE FOREST, IL 60045-1989
Phone number: 847-482-1900
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