Provider Demographics
NPI:1336673987
Name:GREGOR, ADAM ROBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:ROBERT
Last Name:GREGOR
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 1:180 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-2113
Mailing Address - Country:US
Mailing Address - Phone:585-343-5865
Mailing Address - Fax:
Practice Address - Street 1:180 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-2113
Practice Address - Country:US
Practice Address - Phone:585-343-5865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-19
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0597741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice