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General NPI Number Information
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NPI Number | 1144117862
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Entity Type | Organization
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Legal Business Name | GREGORY KON, PC
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Dates
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Enumeration Date | 06/24/2025
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 301 HIGHWAY 71 W STE 102
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City | BASTROP
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State | TX
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Zip | 78602-4111
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Country | US
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Telephone | 512-303-6900
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Fax | 512-321-3597
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Provider Business Mailing Address
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Address Line | 301 HIGHWAY 71 W STE 102
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City | BASTROP
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State | TX
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Zip | 78602-4111
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Country | US
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Telephone | 512-303-6900
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Fax | 512-321-3597
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Authorized Official
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Title or Position | OWNER/GENERAL DENTIST
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Name | DR. GREGORY KON
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Credential |
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Telephone | 626-315-0101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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