Gordon, Jeremiah Daniel

Gordon, Jeremiah Daniel is an individual health care provider with primary practice located at 135 Jenkins St Suite 105A, St Augustine FL 32086-5175. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Gordon, Jeremiah Daniel can be contacted via phone (904) 460-0999.

Contact Information

Primary practice address
135 Jenkins St Suite 105A St Augustine FL 32086-5175
Phone: (904) 460-0999
Fax: (904) 460-0999
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X DN16348 Florida

Profile Details

NPI number 1497870646
LBN Legal business name Gordon, Jeremiah Daniel
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2007
Last updated Feb 11th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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