Provider Demographics
NPI:1053396234
Name:HASSLER, GREGG G JR (DMD)
Entity type:Individual
Prefix:DR
First Name:GREGG
Middle Name:G
Last Name:HASSLER
Suffix:JR
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 1:232 MILAN AVE W
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-2414
Mailing Address - Country:US
Mailing Address - Phone:941-486-8883
Mailing Address - Fax:941-486-8811
Practice Address - Street 1:232 MILAN AVE W
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2414
Practice Address - Country:US
Practice Address - Phone:941-486-8883
Practice Address - Fax:941-486-8811
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN15172122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist