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1134792666
BRIAN KEITH GORDON
PORTSMOUTH, VA
NPI
1134792666
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: UT 12315200-9921)
Enumeration Date
2021-07-22
Last Update Date
2024-07-23
Business Address
BRIAN KEITH GORDON DMD
620 JOHN PAUL JONES CIR STE 275
PORTSMOUTH, VA 23708-2197
Phone number: 757-953-7550
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Mailing Address
BRIAN KEITH GORDON DMD
2054 W 1600 N
PROVO, UT 84604-2282
Phone number: 801-636-1616
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