Provider Demographics
NPI:1366447575
Name:GOR, GREGORY KEVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:KEVIN
Last Name:GOR
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 1:14881 SOUTHWEST FWY
Mailing Address - Street 2:# A-102
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-5016
Mailing Address - Country:US
Mailing Address - Phone:281-240-2545
Mailing Address - Fax:281-240-2544
Practice Address - Street 1:14881 SOUTHWEST FWY
Practice Address - Street 2:# A-102
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5016
Practice Address - Country:US
Practice Address - Phone:281-240-2545
Practice Address - Fax:281-240-2544
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX204851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice