Provider Demographics
NPI:1508964842
Name:LAMANSKY, GREGORY A (DDS)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:A
Last Name:LAMANSKY
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 1:5305 RIB MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-7562
Mailing Address - Country:US
Mailing Address - Phone:715-355-7800
Mailing Address - Fax:715-355-3095
Practice Address - Street 1:5305 RIB MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-7562
Practice Address - Country:US
Practice Address - Phone:715-355-7800
Practice Address - Fax:715-355-3095
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI34351223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics