Gordon, Jodie Lydell

Gordon, Jodie Lydell is an sole proprietor health care provider with primary practice located at 1525 N New St , Kirksville MO 63501-2472. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Gordon, Jodie Lydell can be contacted via phone (660) 665-7908.

Contact Information

Primary practice address
1525 N New St Kirksville MO 63501-2472
Fax: (660) 665-9399
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 014930 Missouri

Profile Details

NPI number 1659487601
LBN Legal business name Gordon, Jodie Lydell
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 22nd, 2006
Last updated Jun 29th, 2023 - about 3 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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