Provider Demographics
NPI:1639339815
Name:GATES, GREGORY PHILLIP (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:PHILLIP
Last Name:GATES
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 1:3249 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-1004
Mailing Address - Country:US
Mailing Address - Phone:513-683-3838
Mailing Address - Fax:
Practice Address - Street 1:3249 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-1004
Practice Address - Country:US
Practice Address - Phone:513-683-3838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0225621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice