Dr. Jonathan Dales Gordon, D.M.D.
Dentist, General Practice in Jacksonville, FL. Individual provider (NPI-1).
NPI number1255669727
StatusActive
Last updated in NPPESDec 14, 2009
Details
- NPI
- 1255669727
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jonathan Dales Gordon
- Credential
- D.M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Nov 21, 2009
- Last updated
- Dec 14, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 18388 | FL | Yes |
Practice location
5425 Verna BlvdJacksonville, FL 32205-4762
Phone 904-826-7923
Mailing address
5425 Verna BlvdJacksonville, FL 32205-4762
Phone 904-826-7923
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