Provider Demographics
NPI:1285857912
Name:ABBOTT, GREGORY NEAL (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:NEAL
Last Name:ABBOTT
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 1:293 SARATOGA RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-4632
Mailing Address - Country:US
Mailing Address - Phone:716-636-8686
Mailing Address - Fax:716-636-0013
Practice Address - Street 1:2430 N FOREST RD
Practice Address - Street 2:
Practice Address - City:GETZVILLE
Practice Address - State:NY
Practice Address - Zip Code:14068-1535
Practice Address - Country:US
Practice Address - Phone:716-636-8686
Practice Address - Fax:716-636-0013
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030796-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice