Provider Demographics
NPI:1134320724
Name:GADWOOD, GRETCHEN S (DDS)
Entity Type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:S
Last Name:GADWOOD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1580 MANN DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-2523
Mailing Address - Country:US
Mailing Address - Phone:510-724-5330
Mailing Address - Fax:510-724-1895
Practice Address - Street 1:1580 MANN DR
Practice Address - Street 2:SUITE B
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-2523
Practice Address - Country:US
Practice Address - Phone:510-724-5330
Practice Address - Fax:510-724-1895
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA542531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice