Provider Demographics
NPI:1639440811
Name:WERNER, GREGORY RAYMOND (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:RAYMOND
Last Name:WERNER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8113 W 94TH AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80021-4515
Mailing Address - Country:US
Mailing Address - Phone:303-432-9773
Mailing Address - Fax:303-432-9792
Practice Address - Street 1:8113 W 94TH AVE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80021-4515
Practice Address - Country:US
Practice Address - Phone:303-432-9773
Practice Address - Fax:303-432-9792
Is Sole Proprietor?:No
Enumeration Date:2012-01-20
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO104401223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics