Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 25145 | CA |
NPI | 1023202298 |
---|---|
Provider Name | Dr. Gary William Greer |
First Address | San Ramon, CA 94583-1639 |
Second Address | San Ramon, CA 94583-1639 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2007 |
Last Update Date | 30/08/2007 |