Provider Demographics
NPI:1073717427
Name:DENTON, GREGORY SCOTT (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:SCOTT
Last Name:DENTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11211 LEBANON RD
Mailing Address - Street 2:STE. 3E & 3F
Mailing Address - City:MT. JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122
Mailing Address - Country:US
Mailing Address - Phone:615-754-0853
Mailing Address - Fax:
Practice Address - Street 1:11211 LEBANON RD
Practice Address - Street 2:STE. 3E & 3F
Practice Address - City:MT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-5545
Practice Address - Country:US
Practice Address - Phone:615-754-0853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN70351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice