Provider Demographics
NPI:1235153339
Name:GAY, GREGORY G (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:G
Last Name:GAY
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 1:3900 MEADOWDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23234-5547
Mailing Address - Country:US
Mailing Address - Phone:804-275-1622
Mailing Address - Fax:804-275-5473
Practice Address - Street 1:3900 MEADOWDALE BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23234-5547
Practice Address - Country:US
Practice Address - Phone:804-275-1622
Practice Address - Fax:804-275-5473
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010057671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice