Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0001X | Dental Public Health | 0160 | NC |
Y | 1223D0001X | Dental Public Health | 16500 | TX |
N | 1223D0001X | Dental Public Health | 55 | MD |
NPI | 1548606510 |
---|---|
Provider Name | Dr. Sharon Michelle Gordon |
First Address | New Bern, NC 28560-4953 |
Second Address | Greenville, NC 27834-5925 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2013 |
Last Update Date | 23/06/2015 |