Provider Demographics
NPI:1699986216
Name:CALVERT, GORDON KEIRN JR (DDS)
Entity type:Individual
Prefix:DR
First Name:GORDON
Middle Name:KEIRN
Last Name:CALVERT
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:400 MARVEL CT
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-4052
Mailing Address - Country:US
Mailing Address - Phone:410-822-7344
Mailing Address - Fax:410-822-1844
Practice Address - Street 1:400 MARVEL CT
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-4052
Practice Address - Country:US
Practice Address - Phone:410-822-7344
Practice Address - Fax:410-822-1844
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD72261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice