Provider Demographics
NPI:1629297387
Name:PAFFORD, GREG (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREG
Middle Name:
Last Name:PAFFORD
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 1:57 E MONTEREY WAY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2616
Mailing Address - Country:US
Mailing Address - Phone:602-264-3234
Mailing Address - Fax:602-264-3273
Practice Address - Street 1:57 E MONTEREY WAY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2616
Practice Address - Country:US
Practice Address - Phone:602-264-3234
Practice Address - Fax:602-264-3273
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ37701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice