Charles G Gordon Dds Llc

LBN: Charles G Gordon Dds Llc
Charles G Gordon Dds Llc is an health care organization with primary practice located at 1026 Eagleridge Blvd , Pueblo CO 81008-2130. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Charles G Gordon Dds Llc can be contacted via phone (719) 544-7672, or through Gordon, Charles via phone (719) 544-7672.

Contact Information

Primary practice address
1026 Eagleridge Blvd Pueblo CO 81008-2130
Phone: (719) 544-7672
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Gordon, Charles
Phone: (719) 544-7672

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 7308 Colorado

Profile Details

NPI number 1588112726
LBN Legal business name Charles G Gordon Dds Llc
DBA Doing business as
Authorized official Gordon, Charles
Entity Organization
Organization subpart 1 Yes
Enumeration date Sep 16th, 2016
Last updated Sep 23rd, 2016 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588112726 NPPES
Colorado MEDICAID 02073088

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