Individual
DR. GREGG S TAIRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2 PROFESSIONAL DR STE 245, GAITHERSBURG, MD 20879-3423
(301) 963-9690
(301) 963-1631
Mailing address
2 PROFESSIONAL DR STE 245, GAITHERSBURG, MD 20879-3423
(301) 963-9690
(301) 963-1631
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9304
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1699977231
NPI ORGANIZATION
—
Enumeration date
11/15/2012
Last updated
11/15/2012
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