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General NPI Number Information
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NPI Number | 1396601076
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Entity Type | Organization
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Legal Business Name | ANDRIANETTE GORDON DDS PLLC
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Dates
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Enumeration Date | 12/26/2025
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 2809 WEHRLE DR STE 11
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-7385
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Country | US
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Telephone | 585-208-0639
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Fax |
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Provider Business Mailing Address
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Address Line | 106 PROSPECT AVE
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City | BUFFALO
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State | NY
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Zip | 14201-2358
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Country | US
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Telephone | 585-208-0639
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDRIANETTE NICOLE GORDON
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Credential | DDS
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Telephone | 585-208-0639
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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