Provider Demographics
NPI:1932132396
Name:MONTEITH, GARY VINCENT (DDS)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:VINCENT
Last Name:MONTEITH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 KIRBY ROAD
Mailing Address - Street 2:
Mailing Address - City:KING
Mailing Address - State:NC
Mailing Address - Zip Code:27021-1047
Mailing Address - Country:US
Mailing Address - Phone:336-983-4565
Mailing Address - Fax:
Practice Address - Street 1:626 KIRBY ROAD
Practice Address - Street 2:
Practice Address - City:KING
Practice Address - State:NC
Practice Address - Zip Code:27021-1047
Practice Address - Country:US
Practice Address - Phone:336-983-4565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC43781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice