Gordon, Michael Jay

Gordon, Michael Jay is an sole proprietor health care provider with primary practice located at 4155 Ferncreek Dr Suite 101, Fayetteville NC 28314-2581. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Gordon, Michael Jay can be contacted via phone (910) 323-8899.

Contact Information

Primary practice address
4155 Ferncreek Dr Suite 101 Fayetteville NC 28314-2581
Phone: (910) 323-8899
Fax: (910) 486-6524
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 5492 North Carolina

Profile Details

NPI number 1114072345
LBN Legal business name Gordon, Michael Jay
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 25th, 2007
Last updated Jul 8th, 2007 - 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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Identifiers

StateTypeNumberIssuer
All States NPI 1114072345 NPPES
North Carolina Other 805329 UCCI
North Carolina Other 5492 UCCI

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