Provider Demographics
NPI:1346274065
Name:PISANI, GREGORY J (DDS)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:J
Last Name:PISANI
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 1:548 W PLUMB LN
Mailing Address - Street 2:SUITE A
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3666
Mailing Address - Country:US
Mailing Address - Phone:775-329-9534
Mailing Address - Fax:
Practice Address - Street 1:548 W PLUMB LN
Practice Address - Street 2:SUITE A
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3666
Practice Address - Country:US
Practice Address - Phone:775-329-9534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1033122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist