| Gordon Orthodontics, Inc. | |
|
840 Tiogue Ave Coventry RI 02816-5914 | |
| (401) 828-1171 | |
| (401) 828-4704 |
| Full Name | Gordon Orthodontics, Inc. |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 840 Tiogue Ave, Coventry, Rhode Island |
| Authorized Official Name and Position | William M Gordon (ORTHODONTIST) |
| Authorized Official Contact | 4018281171 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gordon Orthodontics, Inc. 840 Tiogue Ave Coventry RI 02816-5914 Ph: (401) 828-1171 | Gordon Orthodontics, Inc. 840 Tiogue Ave Coventry RI 02816-5914 Ph: (401) 828-1171 |
| NPI Number | 1104073246 |
|---|---|
| Provider Enumeration Date | 08/20/2008 |
| Last Update Date | 01/31/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104073246 | NPI | - | NPPES |
| 8607-7 | Other | RI | BLUE CROSS DENTAL OF RHODE ISLAND |
| WG00555 | Other | RI | MEDICAL ASSISTANCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 2421 (Rhode Island) | Primary |
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