Provider Demographics
NPI:1235386616
Name:BROWNSBERGER, GREGORY D (DDS)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:D
Last Name:BROWNSBERGER
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 1:3901 BECK RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ST. JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-4923
Mailing Address - Country:US
Mailing Address - Phone:816-232-0081
Mailing Address - Fax:816-232-8851
Practice Address - Street 1:3901 BECK RD
Practice Address - Street 2:SUITE A
Practice Address - City:ST. JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-4923
Practice Address - Country:US
Practice Address - Phone:816-232-0081
Practice Address - Fax:816-232-8851
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO015179122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist