Gregory Brower, D.D.S.
Individual provider Active NPI Dentist · Lordsburg, NM
NPI 1396962452 · NPPES record last updated Mar 11, 2015
Key facts
- NPI
- 1396962452
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DD4210 (NM)
- Practice address
- 530 Demoss St
Lordsburg, NM 88045-2618 - Phone
- (575) 554-2838
- Fax
- (575) 542-8387
- NPI assigned
- Apr 19, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DD4210 | NM | MD | Dentist |
| D3418 | AZ | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DD4210 | NM | Yes |
| General Practice Dentistry | 1223G0001X | D3418 | AZ |
Addresses
Primary practice location
530 Demoss St
Lordsburg, NM 88045-2618
Mailing address
530 Demoss St
Lordsburg, NM 88045-2618
Phone (575) 554-2838
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08977542 | Medicaid | NM |
Other providers in Lordsburg, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.