Provider Demographics
NPI:1659430957
Name:GNEGY DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:GNEGY DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:GNEGY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:269-673-3619
Mailing Address - Street 1:570 LINN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ALLEGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49010
Mailing Address - Country:US
Mailing Address - Phone:269-673-3619
Mailing Address - Fax:269-673-3682
Practice Address - Street 1:570 LINN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:ALLEGAN
Practice Address - State:MI
Practice Address - Zip Code:49010
Practice Address - Country:US
Practice Address - Phone:269-673-3619
Practice Address - Fax:269-673-3682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
625904OtherUNITED CONCORDIA
MID145330OtherBCBSM