Provider Demographics
NPI:1396884490
Name:DIETMEIER, GREGORY W (DDS MS PC)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:W
Last Name:DIETMEIER
Suffix:
Gender:M
Credentials:DDS MS PC
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Mailing Address - Street 1:6850 E HAMPDEN AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224
Mailing Address - Country:US
Mailing Address - Phone:303-758-3114
Mailing Address - Fax:303-758-4080
Practice Address - Street 1:6850 E HAMPDEN AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224
Practice Address - Country:US
Practice Address - Phone:303-758-3114
Practice Address - Fax:303-758-4080
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO60591223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics