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General NPI Number Information
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NPI Number | 1144106642
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Entity Type | Individual
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Provider Name | AUSTIN GORDON DMD
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Gender | Male
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Dates
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Enumeration Date | 08/12/2025
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 744 E LINCOLN HWY STE 110
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City | COATESVILLE
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State | PA
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Zip | 19320-3590
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Country | US
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Telephone | 717-735-6808
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Fax |
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Provider Business Mailing Address
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Address Line | 101 WASHINGTON ST APT 503
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City | CONSHOHOCKEN
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State | PA
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Zip | 19428-2545
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Country | US
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Telephone | 703-624-6071
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS045285
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License Number State | PA
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