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Individual

GREGG S DENSMORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
700 SUNSET DR, STE F, LA GRANDE, OR 97850-1260
(541) 963-8578
(541) 963-8932
Mailing address
700 SUNSET DR, STE F, LA GRANDE, OR 97850-1260
(541) 963-8578
(541) 963-8932

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD18510
OR
332B00000X
Durable Medical Equipment & Medical Supplies

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
057724
DEPT LABOR & INDUSTRIES
WA
05
057724
OR
Enumeration date
07/22/2005
Last updated
01/11/2008
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