Provider Demographics
NPI:1801912654
Name:GORDON, WILLIAM H (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:H
Last Name:GORDON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1904 FRONT ST
Mailing Address - Street 2:SUITE 530
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2583
Mailing Address - Country:US
Mailing Address - Phone:919-383-6661
Mailing Address - Fax:919-384-1991
Practice Address - Street 1:1904 FRONT ST
Practice Address - Street 2:SUITE 530
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2583
Practice Address - Country:US
Practice Address - Phone:919-383-6661
Practice Address - Fax:919-384-1991
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC37891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice