| NPI | 1164957635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JAY GORDON President 828-459-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 9539) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 9539) |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2017-07-27 |