Glenn Anthony Gregory, DDS
Individual provider Active NPI General Practice Dentistry · Rutland, VT
NPI 1831449412 · NPPES record last updated Aug 5, 2015
Key facts
- NPI
- 1831449412
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 016.0090235 (VT)
- Practice address
- 69 Allen St
Suite 10
Rutland, VT 05701-4564 - Phone
- (802) 774-5050
- Fax
- (802) 774-5042
- NPI assigned
- Sep 11, 2012
- 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 |
|---|---|---|---|
| 016.0090235 | VT | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 016.0090235 | VT | Yes |
Addresses
Primary practice location
69 Allen St
Suite 10
Rutland, VT 05701-4564
Mailing address
69 Allen St
Suite 10
Rutland, VT 05701-4564
Phone (802) 774-5050
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1021108 | Medicaid | VT |
Other providers in Rutland, VT
- Green Mountain Infectious Disease LLC
- Green Mountain Oral Surgery LLC
- Chelsea E Greeno
- Richard A Greenspan
- Sarah Greenspan
- Todd David Gregory
- Anna Rebecca Gries
- Karen Grimm
- GRS
- Wilma Guban
All providers in Rutland, VT · General Practice Dentistry in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 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.