Gordon, Phillip Brandon

Gordon, Phillip Brandon is an sole proprietor health care provider with primary practice located at 123 Hill Pond Ln , Statesboro GA 30458-0872. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is his primary health care specialty. Gordon, Phillip Brandon can be contacted via phone (912) 402-5437.

Contact Information

Primary practice address
123 Hill Pond Ln Statesboro GA 30458-0872
Phone: (912) 402-5437
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X DN016102 Georgia
Dental Providers / Pediatric Dentistry 1223P0221X DN016102 Georgia

Profile Details

NPI number 1942833595
LBN Legal business name Gordon, Phillip Brandon
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 21st, 2020
Last updated Jul 30th, 2024 - about 2 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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