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General NPI Number Information
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NPI Number | 1891884235
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Entity Type | Individual
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Provider Name | GREGORY THOMAS KUNZ DDS
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Gender | Male
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 01/31/2018
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Provider Practice Location Address
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Address Line | 3707 N. TWIN CITY HWY.
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City | PORT ARTHUR
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State | TX
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Zip | 77642-2116
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Country | US
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Telephone | 409-962-9391
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Fax | 409-962-3932
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Provider Business Mailing Address
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Address Line | 3707 N TWIN CITY HWY
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City | PORT ARTHUR
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State | TX
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Zip | 77642-2116
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Country | US
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Telephone | 409-962-9391
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Fax | 409-962-3932
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4874
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License Number State | AZ
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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 | 16850
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License Number State | TX
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