Search › Georgia › 1223S0112X
Jacques Gordon, DMD
NPI 1881729820 · on the registry since 2007
Practice
- Address
- 3885 Princeton Lakes Way Sw
Ste 408
Atlanta, GA 30331 - Phone
- (404) 629-6610
- Fax
- (404) 629-6630
- Organisation at this address
- Camp Creek Llc
Resurgens, Llc
Grace Medical Practice Llc
Ispm Asc At Camp Creek Llc
S.Val Plastic Surgery P.C.Inferred from a shared address, not stated in the registry. - Clinicians at this address
- 16
Registry record
- Primary taxonomy
- 1223S0112X
1223S0112X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2010-04-29
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia