Provider Demographics
NPI:1629283726
Name:BARON, GREGORY (DMD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:
Last Name:BARON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 RODNEY ST
Mailing Address - Street 2:
Mailing Address - City:GLEN ROCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07452-2827
Mailing Address - Country:US
Mailing Address - Phone:201-670-8565
Mailing Address - Fax:201-670-8419
Practice Address - Street 1:135 RODNEY ST
Practice Address - Street 2:
Practice Address - City:GLEN ROCK
Practice Address - State:NJ
Practice Address - Zip Code:07452-2827
Practice Address - Country:US
Practice Address - Phone:201-670-8565
Practice Address - Fax:201-670-8419
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI 151571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice