MEDICARE: DR. GREGORY CHARLES ALDRICH DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DS025711L	PA
2	122300000X	Dentist	DN0011208	FL

General Provider Information

NPI Number	:	1760550933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY CHARLES ALDRICH DDS

Provider Business Mailing Address
First Line	:	4322 HIDDEN RIVER ROAD
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34240-8637
Country	:	US
Telephone Number	:	941-792-8232
Fax Number	:	941-243-3142

Provider Business Practice Location Address
First Line	:	3027 MANATEE AVENUE WEST
Second Line	:
City	:	BRANDENTON
State	:	FL
Zip	:	34205
Country	:	US
Telephone Number	:	941-792-8232
Fax Number	:	941-243-3142

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	08/28/2024

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