Provider Demographics
NPI:1811276983
Name:GREGG, KARINA A (DDS)
Entity type:Individual
Prefix:DR
First Name:KARINA
Middle Name:A
Last Name:GREGG
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 1:1691 MELROSE DR
Mailing Address - Street 2:SUITE 160
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-2127
Mailing Address - Country:US
Mailing Address - Phone:760-798-0828
Mailing Address - Fax:
Practice Address - Street 1:1691 MELROSE DR
Practice Address - Street 2:SUITE 160
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-2127
Practice Address - Country:US
Practice Address - Phone:760-798-0828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49535122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist