Provider Demographics
NPI:1821285214
Name:GREGORY, CYNTHIA ANN (DMD)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ANN
Last Name:GREGORY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7520 W WASHINGTON AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-4332
Mailing Address - Country:US
Mailing Address - Phone:702-363-1590
Mailing Address - Fax:702-363-1172
Practice Address - Street 1:7520 W WASHINGTON AVE STE 120
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-4332
Practice Address - Country:US
Practice Address - Phone:702-363-1590
Practice Address - Fax:702-363-1172
Is Sole Proprietor?:No
Enumeration Date:2007-09-28
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5521122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist