Provider Demographics
NPI:1154713212
Name:ARMITAGE, GARY (DDS)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:
Last Name:ARMITAGE
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 1:521 PARNASSUS AVE
Mailing Address - Street 2:UCSF SCHOOL OF DENTISTRY
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0650
Mailing Address - Country:US
Mailing Address - Phone:415-476-8955
Mailing Address - Fax:415-502-4990
Practice Address - Street 1:521 PARNASSUS AVE
Practice Address - Street 2:UCSF SCHOOL OF DENTISTRY
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-0650
Practice Address - Country:US
Practice Address - Phone:415-476-8955
Practice Address - Fax:415-502-4990
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19023122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist