Provider Demographics
NPI:1558555318
Name:SNOW, GREGORY ALAN (DDS)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:ALAN
Last Name:SNOW
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 1:1000 LOUISIANA ST
Mailing Address - Street 2:SUITE 3760
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-5005
Mailing Address - Country:US
Mailing Address - Phone:713-652-0555
Mailing Address - Fax:713-652-0666
Practice Address - Street 1:1000 LOUISIANA ST
Practice Address - Street 2:SUITE 3760
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-5005
Practice Address - Country:US
Practice Address - Phone:713-652-0555
Practice Address - Fax:713-652-0666
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice