| J.R. Gregg LLC | |
|
1201 Se 223rd Ave Ste 220 Gresham OR 97030-2578 | |
| (503) 489-4546 | |
| Not Available |
| Full Name | J.R. Gregg LLC |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1201 Se 223rd Ave Ste 220, Gresham, Oregon |
| Authorized Official Name and Position | Joseph Randall Gregg (ORTHODONTIST/OWNER) |
| Authorized Official Contact | 8128871960 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J.R. Gregg LLC 1720 N. Old Bruceville Rd. Vincennes IN 47591 Ph: (812) 887-1960 | J.R. Gregg LLC 1201 Se 223rd Ave Ste 220 Gresham OR 97030-2578 Ph: (503) 489-4546 |
| NPI Number | 1487205233 |
|---|---|
| Provider Enumeration Date | 09/24/2019 |
| Last Update Date | 09/24/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487205233 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | () | Primary |
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