Individual
KENNETH JOSEPH GREGIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
413 W SAINT CHARLES RD, VILLA PARK, IL 60181-2432
(630) 629-3120
(630) 629-3167
Mailing address
413 W SAINT CHARLES RD, VILLA PARK, IL 60181-2432
(630) 629-3120
(630) 629-3167
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19015201
IL
Other
Enumeration date
11/10/2006
Last updated
07/08/2007
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