MEDICARE: DR. GREGORY RICE DDS

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	5137	WA

General Provider Information

NPI Number	:	1790928463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY RICE DDS

Provider Business Mailing Address
First Line	:	300 LENORA ST
Second Line	:	#246
City	:	SEATTLE
State	:	WA
Zip	:	98121-2411
Country	:	US
Telephone Number	:	206-914-8180
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 LENORA ST
Second Line	:	#246
City	:	SEATTLE
State	:	WA
Zip	:	98121-2411
Country	:	US
Telephone Number	:	206-914-8180
Fax Number	:

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

Provider Enumeration Date	:	04/10/2009
Last Update Date	:	05/07/2013

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