Jeremiah D Gordon, Dmd, PA
NPI #1376781864 in St Augustine, Florida
Provider Information
- NPI Number
- 1376781864
- Entity Type
- Organization
- Organization Name
- Jeremiah D Gordon, Dmd, PA
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jan 22, 2009
- Last Updated
- Jan 22, 2009
Practice Location
- Address
- 53 WILLOW DR
- City
- St Augustine
- State
- Florida
- ZIP Code
- 32080-5936
- Phone
- (904) 471-5336
Authorized Official
- Name
- DR. JEREMIAH D GORDON, DMD
- Title
- DENTIS/OWNER
- Phone
- (904) 460-0999
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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