Provider Demographics
NPI:1649423393
Name:BRUMMITT, GREGORY EARL (DMD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:EARL
Last Name:BRUMMITT
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 1:3489 BRODHEAD RD
Mailing Address - Street 2:
Mailing Address - City:MONACA
Mailing Address - State:PA
Mailing Address - Zip Code:15061
Mailing Address - Country:US
Mailing Address - Phone:724-728-2533
Mailing Address - Fax:724-728-0233
Practice Address - Street 1:3489 BRODHEAD RD
Practice Address - Street 2:
Practice Address - City:MONACA
Practice Address - State:PA
Practice Address - Zip Code:15061
Practice Address - Country:US
Practice Address - Phone:724-728-2533
Practice Address - Fax:724-728-0233
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADSO19523L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice