Jason R. Gordon D.d.s. P. C.

NPI #1629301395 in Bronx, New York

Provider Information

NPI Number: 1629301395
Entity Type: Organization
Organization Name: Jason R. Gordon D.d.s. P. C.
Primary Specialty: Dentist - General Practice
Enumeration Date: Sep 14, 2009
Last Updated: Sep 14, 2009

Practice Location

Address: 724 PELHAM PKWY S
City: Bronx
State: New York
ZIP Code: 10462-1029
Phone: (347) 281-9444

Authorized Official

Name: DR. JASON R GORDON
Title: DENTIST/OWNER
Phone: (347) 281-9444

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary
Dentist - Periodontics — Periodontics	1223P0300X
Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	1223S0112X
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X

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