Provider Demographics
NPI:1528198355
Name:FRESE, GREGORY C III (DDS)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:C
Last Name:FRESE
Suffix:III
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 1:1000 OHIO PIKE
Mailing Address - Street 2:#101
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-2346
Mailing Address - Country:US
Mailing Address - Phone:513-752-9160
Mailing Address - Fax:513-752-9120
Practice Address - Street 1:1000 OHIO PIKE
Practice Address - Street 2:#101
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-2346
Practice Address - Country:US
Practice Address - Phone:513-752-9160
Practice Address - Fax:513-752-9120
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH158211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice