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Provider Information for 1013261494

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. GREGORY PEARCE THURSTON DDS

Gender: MALE

Individual NPI: 1013261494

Calendar   Last Updated:  2021-10-05
  Certification Date:  2021-10-05

Details

Name Value
NPI 1013261494
Enumeration Date 2012-11-06
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 1486 PALM ST
SAN LUIS OBISPO, CA 93401-2938
United States

Phone: 805-543-8675 | Fax:
View Map External Link
Primary Practice Address 1486 PALM ST
SAN LUIS OBISPO, CA 93401-2938
United States

Phone: 805-543-8675 | Fax: 805-543-8696
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist CA 61788