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NPI Code Detail

MEDICARE: DR. DAVID J GORDON II D.D.S.

MEDICARE:  DR. DAVID J GORDON II D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry17799TX

General Provider Information

NPI Number : 1811903289
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID J GORDON II D.D.S.
Provider Business Mailing Address
First Line : 300 WEST AVE
Second Line : SUITE 1312
City : AUSTIN
State : TX
Zip : 78701-3840
Country : US
Telephone Number : 512-708-8900
Fax Number : 512-494-8088
Provider Business Practice Location Address
First Line : 300 WEST AVE
Second Line : SUITE 1312
City : AUSTIN
State : TX
Zip : 78701-3840
Country : US
Telephone Number : 512-708-8900
Fax Number : 512-494-8088
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2006
Last Update Date : 07/08/2007

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Directions to “ DR. DAVID J GORDON II D.D.S.” Practice Location

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