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General NPI Number Information
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NPI Number | 1982725990
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Entity Type | Individual
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Provider Name | GREGORY JOHN GOSSICK D. D. S.
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Gender | Male
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 37 N WASHINGTON ST
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City | OXFORD
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State | MI
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Zip | 48371-4673
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Country | US
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Telephone | 248-628-6600
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Fax |
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Provider Business Mailing Address
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Address Line | 5741 BROOKS DR
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City | OXFORD
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State | MI
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Zip | 48371-4185
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Country | US
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Telephone |
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901013949
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License Number State | MI
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