| Dr. Gregory Lee Derry D.d.s. Ltd | |
|
75 E Birch St Canton IL 61520-1300 | |
| (309) 647-2244 | |
| Not Available |
| Full Name | Dr. Gregory Lee Derry D.d.s. Ltd |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 75 E Birch St, Canton, Illinois |
| Authorized Official Name and Position | Gregory Lee Derry (OWNER) |
| Authorized Official Contact | 3096472244 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Gregory Lee Derry D.d.s. Ltd 75 E Birch St Canton IL 61520-1300 Ph: (309) 647-2244 | Dr. Gregory Lee Derry D.d.s. Ltd 75 E Birch St Canton IL 61520-1300 Ph: (309) 647-2244 |
| NPI Number | 1952580094 |
|---|---|
| Provider Enumeration Date | 10/25/2007 |
| Last Update Date | 10/25/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952580094 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 1916263 (Illinois) | Primary |
Associates In Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 336 N Main Street, Canton, IL 61520 Phone: 309-647-3331 Fax: 309-649-5439 |