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Organization
STANLEY W. GRESHAM DDS
Active
Organization
STANLEY W. GRESHAM DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STANLEY W GRESHAM DDS (OWNER)
(906) 932-2730
Entity
Organization
Contact information
Practice address
212 E AURORA ST, IRONWOOD, MI 49938-2112
(906) 932-2730
(906) 932-5832
Mailing address
212 E AURORA ST, IRONWOOD, MI 49938-2112
(906) 932-2730
(906) 932-5832
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528130820
—
MI
05
—
33401100
—
WI
Enumeration date
04/26/2022
Last updated
05/24/2022
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