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General NPI Number Information
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NPI Number | 1386846087
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Entity Type | Organization
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Legal Business Name | GREGORY D. PRIESTON DDS PC
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5 EVERSLEY AVE SUITE 101
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City | NORWALK
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State | CT
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Zip | 06851-5821
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Country | US
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Telephone | 203-853-6626
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Fax | 203-853-7073
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Provider Business Mailing Address
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Address Line | 5 EVERSLEY AVE SUITE 101
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City | NORWALK
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State | CT
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Zip | 06851-5821
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Country | US
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Telephone | 203-853-6626
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Fax | 203-853-7073
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GREGORY DEEMS PRIESTON
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Credential |
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Telephone | 203-853-6626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 005682
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License Number State | CT
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