Provider Demographics
NPI:1790878619
Name:GREGSTON, MARK DEWAYNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:DEWAYNE
Last Name:GREGSTON
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Gender:M
Credentials:DDS
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Mailing Address - Street 1:7150 E HAMPDEN AVE
Mailing Address - Street 2:#200
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-3025
Mailing Address - Country:US
Mailing Address - Phone:303-758-2366
Mailing Address - Fax:303-756-1460
Practice Address - Street 1:7150 E HAMPDEN AVE
Practice Address - Street 2:#200
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-3025
Practice Address - Country:US
Practice Address - Phone:303-758-2366
Practice Address - Fax:303-756-1460
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CO87201223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics