| Stanley W. Gresham Dds | |
|
212 E Aurora St Ironwood MI 49938-2112 | |
| (906) 932-2730 | |
| (906) 932-5832 |
| Full Name | Stanley W. Gresham Dds |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 212 E Aurora St, Ironwood, Michigan |
| Authorized Official Name and Position | Stanley W Gresham (OWNER) |
| Authorized Official Contact | 9069322730 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stanley W. Gresham Dds 212 E Aurora St Ironwood MI 49938-2112 Ph: (906) 932-2730 | Stanley W. Gresham Dds 212 E Aurora St Ironwood MI 49938-2112 Ph: (906) 932-2730 |
| NPI Number | 1992449854 |
|---|---|
| Provider Enumeration Date | 04/26/2022 |
| Last Update Date | 05/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992449854 | NPI | - | NPPES |
| 33401100 | Medicaid | WI | |
| 1528130820 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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