Individual
GREGORY ROBERT KNUTSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1001 W BROADWAY, FARMINGTON, NM 87401-5638
(505) 327-4796
(505) 325-9113
Mailing address
1001 W. BROADWAY AVE., FARMINGTON, NM 87401-5638
(505) 327-4796
(505) 325-9113
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
28927
TX
1223G0001X
General Practice Dentistry
Primary
DD4661
NM
Other
Enumeration date
06/18/2013
Last updated
04/18/2017
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