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General NPI Number Information
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NPI Number | 1720231822
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Entity Type | Organization
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Legal Business Name | T. GORDON HANDY DDS P.A.
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Dates
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Enumeration Date | 11/03/2008
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Last Update Date | 11/03/2008
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Provider Practice Location Address
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Address Line | 1700 S. HAWTHORNE RD.
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City | WINSTON-SALEM
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State | NC
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Zip | 27103-4016
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Country | US
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Telephone | 336-765-7870
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Fax | 336-765-3830
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Provider Business Mailing Address
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Address Line | 1700 S. HAWTHORNE RD.
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City | WINSTON-SALEM
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State | NC
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Zip | 27103-4016
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Country | US
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Telephone | 336-765-7870
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Fax | 336-765-3830
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Authorized Official
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Title or Position | PRESIDENT
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Name | T. GORDON HANDY, JR
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Credential |
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Telephone | 336-765-7870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 6568
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License Number State | NC
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