Provider Demographics
NPI:1548473697
Name:GREGORY B WATERS, DDS, PC
Entity type:Organization
Organization Name:GREGORY B WATERS, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:B
Authorized Official - Last Name:WATERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-420-3233
Mailing Address - Street 1:8850 W 58TH AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-2252
Mailing Address - Country:US
Mailing Address - Phone:303-420-3233
Mailing Address - Fax:303-421-1615
Practice Address - Street 1:8850 W 58TH AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-2252
Practice Address - Country:US
Practice Address - Phone:303-420-3233
Practice Address - Fax:303-421-1615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8157261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental