MEDICARE: DR. GREGORY LEE HAUSER D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	26863	CA

General Provider Information

NPI Number	:	1144427113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY LEE HAUSER D.D.S.

Provider Business Mailing Address
First Line	:	1290 ROSEVINE LN
Second Line	:
City	:	ARROYO GRANDE
State	:	CA
Zip	:	93420-5083
Country	:	US
Telephone Number	:	805-440-8759
Fax Number	:	805-481-6249

Provider Business Practice Location Address
First Line	:	1555 EL CAMINO REAL
Second Line	:
City	:	ARROYO GRANDE
State	:	CA
Zip	:	93420-2236
Country	:	US
Telephone Number	:	805-481-3256
Fax Number	:	805-481-6249

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2007
Last Update Date	:	05/30/2024

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