Provider Demographics
NPI:1942269709
Name:MCMAHON, GREGORY THOMAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:THOMAS
Last Name:MCMAHON
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 1:2711 ALBANY POST RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:NY
Mailing Address - Zip Code:12549-2158
Mailing Address - Country:US
Mailing Address - Phone:845-457-1647
Mailing Address - Fax:845-818-3921
Practice Address - Street 1:2711 ALBANY POST RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:NY
Practice Address - Zip Code:12549-2158
Practice Address - Country:US
Practice Address - Phone:845-457-1647
Practice Address - Fax:845-818-3921
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0432451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice