Provider Demographics
NPI:1215931688
Name:PRIESTON, GREGORY DEEMS (DDS)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:DEEMS
Last Name:PRIESTON
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:P.O BOX 1570
Mailing Address - Street 2:
Mailing Address - City:LITTLE RIVER
Mailing Address - State:SC
Mailing Address - Zip Code:29566
Mailing Address - Country:US
Mailing Address - Phone:203-504-2067
Mailing Address - Fax:203-853-7073
Practice Address - Street 1:4032-2 RIVER OAKS DR.
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579
Practice Address - Country:US
Practice Address - Phone:843-903-8800
Practice Address - Fax:203-853-7073
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC93481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice