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General NPI Number Information
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NPI Number | 1104154749
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Entity Type | Organization
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Legal Business Name | CYNTHIA GREGORY DMD PC
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Dates
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Enumeration Date | 11/19/2009
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Last Update Date | 11/19/2009
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Provider Practice Location Address
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Address Line | 7520 W WASHINGTON AVE STE 120
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City | LAS VEGAS
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State | NV
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Zip | 89128-4332
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Country | US
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Telephone | 702-363-1590
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Fax | 702-363-1172
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Provider Business Mailing Address
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Address Line | 7520 W WASHINGTON AVE STE 120
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City | LAS VEGAS
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State | NV
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Zip | 89128-4332
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Country | US
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Telephone | 702-363-1590
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Fax | 702-363-1172
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. CYNTHIA ANN GREGORY
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Credential | DMD
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Telephone | 702-423-0443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 5521
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License Number State | NV
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