Individual
GREGORY R ERENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
620 PERIMETER DR, STE 100, LEXINGTON, KY 40517-4125
(859) 268-4423
(859) 268-0010
Mailing address
620 PERIMETER DR, STE 100, LEXINGTON, KY 40517-4125
(859) 268-4423
(859) 268-0010
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4957
KY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
4957
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60049574
—
KY
05
—
64049570
—
KY
Enumeration date
06/22/2005
Last updated
02/20/2012
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