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General NPI Number Information
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NPI Number | 1902012792
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Entity Type | Organization
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Legal Business Name | DR. WILLIAM H. GORDON, D.D.S., P.A.
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1904 FRONT ST STE 530
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City | DURHAM
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State | NC
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Zip | 27705-2583
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Country | US
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Telephone | 919-383-6661
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Fax | 919-384-1991
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Provider Business Mailing Address
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Address Line | 1904 FRONT ST STE 530
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City | DURHAM
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State | NC
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Zip | 27705-2583
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Country | US
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Telephone | 919-383-6661
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Fax | 919-384-1991
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Authorized Official
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Title or Position | INSURANCE SPECIALIST
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Name | MRS. LEIGH K. BLANTON
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Credential |
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Telephone | 919-383-6661
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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 | 3789
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License Number State | NC
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