Provider Demographics
NPI:1811026834
Name:G & M ORTHODONTICS
Entity Type:Organization
Organization Name:G & M ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:GARN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-987-9494
Mailing Address - Street 1:20261 E OCOTILLO RD
Mailing Address - Street 2:SUITE #130
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85242-8806
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:480-987-0345
Practice Address - Street 1:20261 E OCOTILLO RD
Practice Address - Street 2:SUITE #130
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85242-8806
Practice Address - Country:US
Practice Address - Phone:480-987-9494
Practice Address - Fax:480-987-0345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ53481223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty