Provider Demographics
NPI:1245353382
Name:FREI, GREGORY JOSEPH (DDS)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:JOSEPH
Last Name:FREI
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 1:22101 STATE HIGHWAY 46 W
Mailing Address - Street 2:
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-6771
Mailing Address - Country:US
Mailing Address - Phone:830-438-2273
Mailing Address - Fax:830-438-3183
Practice Address - Street 1:22101 STATE HIGHWAY 46 W
Practice Address - Street 2:
Practice Address - City:SPRING BRANCH
Practice Address - State:TX
Practice Address - Zip Code:78070-6771
Practice Address - Country:US
Practice Address - Phone:830-438-2273
Practice Address - Fax:830-438-3183
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice