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Individual

DR. GARY THOMAS GREGG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
700 N DEVINE RD, VANCOUVER, WA 98661-6964
(360) 750-1385
(360) 750-1798
Mailing address
700 N DEVINE RD, VANCOUVER, WA 98661-6964
(360) 750-1385
(360) 750-1798

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00005828
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
073914000
BLUE CROSS/BLUE SHIELD
WA
01
DE00005828
WA DENTAL LICENSE #
WA
01
DELTA DENTAL
INSURANCE IDENTIFIER
WA
Enumeration date
11/21/2005
Last updated
07/08/2007
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