| W . Jarrod Gregg, Dds, Llc | |
|
1148 Logan Sewell Dr Vidalia LA 71373-3342 | |
| (318) 336-5711 | |
| Not Available |
| Full Name | W . Jarrod Gregg, Dds, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1148 Logan Sewell Dr, Vidalia, Louisiana |
| Authorized Official Name and Position | Melissa W Gregg (OFFICE MANAGER) |
| Authorized Official Contact | 3183365711 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| W . Jarrod Gregg, Dds, Llc 1148 Logan Sewell Dr Vidalia LA 71373-3342 Ph: () - | W . Jarrod Gregg, Dds, Llc 1148 Logan Sewell Dr Vidalia LA 71373-3342 Ph: (318) 336-5711 |
| NPI Number | 1407479819 |
|---|---|
| Provider Enumeration Date | 05/20/2020 |
| Last Update Date | 05/20/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407479819 | NPI | - | NPPES |
| 29821 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |