| NPI | 1568522621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY P. GORDON C.E.O. 215-639-0571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ DS028594L) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2020-08-22 |