Provider Demographics
NPI:1720245251
Name:WADLEIGH, GREGORY ANTHONY (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:ANTHONY
Last Name:WADLEIGH
Suffix:
Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:42407 N VISION WAY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-1480
Mailing Address - Country:US
Mailing Address - Phone:623-551-7500
Mailing Address - Fax:
Practice Address - Street 1:42407 N VISION WAY
Practice Address - Street 2:SUITE 101
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-1480
Practice Address - Country:US
Practice Address - Phone:623-551-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2010-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD70501223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics