Provider Demographics
NPI:1154331825
Name:PERIOIMPLANT ASSOCIATES
Entity Type:Organization
Organization Name:PERIOIMPLANT ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALBRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:502-897-9417
Mailing Address - Street 1:3620 BLACKISTON BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-8529
Mailing Address - Country:US
Mailing Address - Phone:812-948-0408
Mailing Address - Fax:812-948-0409
Practice Address - Street 1:3620 BLACKISTON BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-8529
Practice Address - Country:US
Practice Address - Phone:812-948-0408
Practice Address - Fax:812-948-0409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty