Provider Demographics
NPI:1730633678
Name:KASS, GREGORY (DDS)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:
Last Name:KASS
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 1:738 US HIGHWAY 9
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-3800
Mailing Address - Country:US
Mailing Address - Phone:845-896-5151
Mailing Address - Fax:
Practice Address - Street 1:738 US HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-3800
Practice Address - Country:US
Practice Address - Phone:845-896-5151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0587521223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics