Provider Demographics
NPI:1033211198
Name:GREGORY P BIALEK DDS PA
Entity Type:Organization
Organization Name:GREGORY P BIALEK DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:P
Authorized Official - Last Name:BIALEK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-788-1717
Mailing Address - Street 1:360 EXCHANGE ST NW
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027
Mailing Address - Country:US
Mailing Address - Phone:704-788-1717
Mailing Address - Fax:704-788-1752
Practice Address - Street 1:360 EXCHANGE ST NW
Practice Address - Street 2:SUITE 101
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027
Practice Address - Country:US
Practice Address - Phone:704-788-1717
Practice Address - Fax:704-788-1752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC7058122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty