Provider Demographics
NPI:1417937293
Name:GANSER, GREGORY WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:WILLIAM
Last Name:GANSER
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 1:3996 FULTON DR NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-3051
Mailing Address - Country:US
Mailing Address - Phone:330-493-1876
Mailing Address - Fax:330-493-3457
Practice Address - Street 1:3996 FULTON DR NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-3051
Practice Address - Country:US
Practice Address - Phone:330-493-1876
Practice Address - Fax:330-493-3457
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH197701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice