Provider Demographics
NPI:1912181611
Name:RONALD L GREGO, DMD, PC
Entity Type:Organization
Organization Name:RONALD L GREGO, DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:LEW
Authorized Official - Last Name:GREGO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:724-674-7981
Mailing Address - Street 1:3131 WILMINGTON ROAD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105
Mailing Address - Country:US
Mailing Address - Phone:724-652-9638
Mailing Address - Fax:724-652-9638
Practice Address - Street 1:3131 WILMINGTON RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1175
Practice Address - Country:US
Practice Address - Phone:724-674-7981
Practice Address - Fax:724-652-9638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026521L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty