Provider Demographics
NPI:1649432360
Name:GRESS, NANCY ELIZABETH (DDS)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:ELIZABETH
Last Name:GRESS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 LEEFIELD GATE
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-1611
Mailing Address - Country:US
Mailing Address - Phone:631-427-6104
Mailing Address - Fax:
Practice Address - Street 1:3 LEEFIELD GATE
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-1611
Practice Address - Country:US
Practice Address - Phone:631-427-6104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0418481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice