# GREGORY DENTAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770305815
- **Authorized official:** DERRICK GREGORY (OWNER)
- **Authorized official phone:** (615) 444-0322

## Contact information

- **Practice address:** 1746 W MAIN ST, LEBANON, TN 37087-3194
- **Practice address phone:** (615) 444-0322
- **Mailing address:** 1746 W MAIN ST, LEBANON, TN 37087-3194
- **Mailing address phone:** (615) 444-0322

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 10/29/2024
- **Last updated:** 10/29/2024