Provider Demographics
NPI:1164554325
Name:GAY, GRETCHEN N (DMD)
Entity Type:Individual
Prefix:MRS
First Name:GRETCHEN
Middle Name:N
Last Name:GAY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5TH STREET D-2
Mailing Address - Street 2:PRADO ALTO
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-749-0221
Mailing Address - Fax:
Practice Address - Street 1:GEORGETTI #13
Practice Address - Street 2:SUITE #3
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617
Practice Address - Country:US
Practice Address - Phone:787-846-7247
Practice Address - Fax:787-846-7247
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2161122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist