Provider Demographics
NPI:1386956472
Name:REECE, GREGORY (DMD)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:REECE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3014 BAUCCOM ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269
Mailing Address - Country:US
Mailing Address - Phone:704-596-6767
Mailing Address - Fax:704-596-7790
Practice Address - Street 1:3014 BAUCCOM ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269
Practice Address - Country:US
Practice Address - Phone:704-596-6767
Practice Address - Fax:704-596-7790
Is Sole Proprietor?:No
Enumeration Date:2010-07-06
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9071122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist