Provider Demographics
NPI:1710595079
Name:SINGER, GREGORY HARRISON (DDS)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:HARRISON
Last Name:SINGER
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 1:3873 INVERNESS CMN
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94551-4906
Mailing Address - Country:US
Mailing Address - Phone:831-295-8996
Mailing Address - Fax:
Practice Address - Street 1:400 E ORANGEBURG AVE STE 4
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-5365
Practice Address - Country:US
Practice Address - Phone:209-524-4763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1049891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice