Individual
DR. GRETCHEN GIGI GORMAN-LYDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
100 BRUNSWICK MEDICAL CENTER PKWY NE, BOLIVIA, NC 28422-1001
(910) 253-9000
Mailing address
1013 TROUT LN, CAROLINA BEACH, NC 28428-6878
(585) 259-4637
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
043204
NY
122300000X
Dentist
Primary
12579
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043204
STATE LICENSE
NY
01
—
12579
NC STATE DENTAL LICENSE
NC
Enumeration date
04/16/2007
Last updated
02/07/2022
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