Provider Demographics
NPI:1225053283
Name:GRESS, GENE GORDON (DDS)
Entity Type:Individual
Prefix:DR
First Name:GENE
Middle Name:GORDON
Last Name:GRESS
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 1:9801 ANDERSON MILL RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-2274
Mailing Address - Country:US
Mailing Address - Phone:512-258-0670
Mailing Address - Fax:512-258-0672
Practice Address - Street 1:9801 ANDERSON MILL RD
Practice Address - Street 2:SUITE 109
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-2274
Practice Address - Country:US
Practice Address - Phone:512-258-0670
Practice Address - Fax:512-258-0672
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13087122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX090924404Medicaid