Provider Demographics
NPI:1275607343
Name:TRENT, GREGG EUGENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGG
Middle Name:EUGENE
Last Name:TRENT
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 1:14777 LOS GATOS BLVD # 103
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2027
Mailing Address - Country:US
Mailing Address - Phone:408-358-2161
Mailing Address - Fax:408-358-2164
Practice Address - Street 1:14777 LOS GATOS BLVD # 103
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2027
Practice Address - Country:US
Practice Address - Phone:408-358-2161
Practice Address - Fax:408-358-2164
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0368431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice