Individual
DR. GLENN ANTHONY GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
69 ALLEN ST, SUITE 10, RUTLAND, VT 05701-4564
(802) 774-5050
(802) 774-5042
Mailing address
69 ALLEN ST, SUITE 10, RUTLAND, VT 05701-4564
(802) 774-5050
(802) 774-5042
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
016.0090235
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021108
—
VT
Enumeration date
09/11/2012
Last updated
08/05/2015
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