Gordon, Randall R
Gordon, Randall R is an sole proprietor health care provider with primary practice located at 1420 S Mills Ave Suite G, Lodi CA 95242-4291. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Gordon, Randall R can be contacted via phone (209) 369-1484.Contact Information
Primary practice address
1420 S Mills Ave Suite G
Lodi CA 95242-4291
Phone: (209) 369-1484
Fax: (209) 366-0998
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Periodontics | 1223P0300X | 40598 | California |
Profile Details
| NPI number | 1851498877 |
|---|---|
| LBN Legal business name | Gordon, Randall R |
| Credentials | DDS, MS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 20th, 2006 |
| 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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