Gordon, Mark Richard

Gordon, Mark Richard is an sole proprietor health care provider with primary practice located at 305 W 12Th Ave , Columbus OH 43210-1267. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Gordon, Mark Richard can be contacted via phone (614) 688-3763.

Contact Information

Primary practice address
305 W 12Th Ave Columbus OH 43210-1267
Phone: (614) 688-3763
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Periodontics 1223P0300X VA6393 Virginia
Dental Providers / Periodontics 1223P0300X 14432 Ohio
Dental Providers / Periodontics 1223P0300X 14332 Ohio

Profile Details

NPI number 1356365126
LBN Legal business name Gordon, Mark Richard
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 26th, 2006
Last updated Nov 28th, 2020 - about 5 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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