Provider Demographics
NPI:1760584833
Name:OWENS, GREGORY DEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:DEAN
Last Name:OWENS
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 1:640 W MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-2559
Mailing Address - Country:US
Mailing Address - Phone:276-676-2616
Mailing Address - Fax:276-676-2616
Practice Address - Street 1:640 W MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-2559
Practice Address - Country:US
Practice Address - Phone:276-676-2616
Practice Address - Fax:276-676-2616
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010057581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice