| NPI | 1427170208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD E. GORDON Owner 401-751-8029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: RI DNT1823) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2020-08-22 |