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General NPI Number Information
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NPI Number | 1649549742
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Entity Type | Organization
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Legal Business Name | GREGORY DENTAL ASSOCIATES, P.C.
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Dates
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Enumeration Date | 12/19/2011
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Last Update Date | 12/19/2011
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Provider Practice Location Address
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Address Line | 2218 BRISTOL PIKE
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City | BENSALEM
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State | PA
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Zip | 19020-5210
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Country | US
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Telephone | 215-639-6133
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Fax | 215-638-0877
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Provider Business Mailing Address
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Address Line | 2218 BRISTOL PIKE
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City | BENSALEM
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State | PA
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Zip | 19020-5210
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Country | US
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Telephone | 215-639-6133
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Fax | 215-638-0877
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Authorized Official
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Title or Position | PRESIDENT/DENTIST
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Name | CHRISTINA ANN GREGORY
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Credential | D.M.D.
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Telephone | 215-639-6133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS035192
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License Number State | PA
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