Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 5319 | AZ |
NPI | 1003022039 |
---|---|
Provider Name | Dr. Gregory Alan Kammeyer |
First Address | Sun City West, AZ 85375-4438 |
Second Address | Sun City West, AZ 85375-4438 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 08/07/2007 |