Provider Demographics
NPI:1487764122
Name:MOVSESIAN, GREGORY G (DDS)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:G
Last Name:MOVSESIAN
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 1:5500 ARMSTRONG RD
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015
Mailing Address - Country:US
Mailing Address - Phone:269-223-5221
Mailing Address - Fax:269-223-6502
Practice Address - Street 1:5500 ARMSTRONG RD
Practice Address - Street 2:DENTAL SERVICE, DEPARTMENT 160
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-1014
Practice Address - Country:US
Practice Address - Phone:269-966-5600
Practice Address - Fax:269-660-6024
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0131831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice