Provider Demographics
NPI:1710188230
Name:FIELD, GARY LEIGH (DDS)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:LEIGH
Last Name:FIELD
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 1:9475 BRIAR VILLAGE PT
Mailing Address - Street 2:310
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-7901
Mailing Address - Country:US
Mailing Address - Phone:719-598-0872
Mailing Address - Fax:719-598-8899
Practice Address - Street 1:9475 BRIAR VILLAGE PT
Practice Address - Street 2:310
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7901
Practice Address - Country:US
Practice Address - Phone:719-598-0872
Practice Address - Fax:719-598-8899
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO066241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice