Provider Demographics
NPI:1255496840
Name:MATHIEU, GREGORY P (DDS)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:P
Last Name:MATHIEU
Suffix:
Gender:M
Credentials:DDS
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Other - Credentials:
Mailing Address - Street 1:14425 W MCDOWELL RD
Mailing Address - Street 2:SUITE F102
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-2516
Mailing Address - Country:US
Mailing Address - Phone:623-536-0079
Mailing Address - Fax:623-535-5176
Practice Address - Street 1:14425 W MCDOWELL RD
Practice Address - Street 2:SUITE F102
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-2516
Practice Address - Country:US
Practice Address - Phone:623-536-0079
Practice Address - Fax:623-535-5176
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2009-11-23
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Provider Licenses
StateLicense IDTaxonomies
AZ79141223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry