Provider Demographics
NPI:1902026586
Name:KUWABARA, GREGORY H (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:H
Last Name:KUWABARA
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:16960 BASTANCHURY RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-1711
Mailing Address - Country:US
Mailing Address - Phone:714-986-1699
Mailing Address - Fax:714-986-1690
Practice Address - Street 1:16960 BASTANCHURY RD
Practice Address - Street 2:SUITE B
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-1711
Practice Address - Country:US
Practice Address - Phone:714-986-1699
Practice Address - Fax:714-986-1690
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2012-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA344551223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics