Provider Demographics
NPI:1982975934
Name:POWNING, GREGORY V (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:V
Last Name:POWNING
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 1:1601 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3464
Mailing Address - Country:US
Mailing Address - Phone:775-323-3574
Mailing Address - Fax:775-323-8233
Practice Address - Street 1:1601 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3464
Practice Address - Country:US
Practice Address - Phone:775-323-3574
Practice Address - Fax:775-323-8233
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-23
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV846122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist