Provider Demographics
NPI:1639221336
Name:KALBFLEISCH, GREGG HAL (DDS)
Entity type:Individual
Prefix:DR
First Name:GREGG
Middle Name:HAL
Last Name:KALBFLEISCH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:8006 FOX HILL DR
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-5254
Mailing Address - Country:US
Mailing Address - Phone:303-772-3696
Mailing Address - Fax:303-776-4895
Practice Address - Street 1:1361 FRANCIS ST
Practice Address - Street 2:SUITE 101
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-2576
Practice Address - Country:US
Practice Address - Phone:303-772-8585
Practice Address - Fax:303-776-4895
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COH-D-1-002261223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery