Provider Demographics
NPI:1093765349
Name:PAPPAS, GREGORY J (DMD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:J
Last Name:PAPPAS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 ELM ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04953-3125
Mailing Address - Country:US
Mailing Address - Phone:207-368-4325
Mailing Address - Fax:207-368-5079
Practice Address - Street 1:42 ELM ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:ME
Practice Address - Zip Code:04953-3125
Practice Address - Country:US
Practice Address - Phone:207-368-4325
Practice Address - Fax:207-368-5079
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3060122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist