Organization
J.R. GREGG LLC
Active
Organization
J.R. GREGG LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH RANDALL GREGG DDS, MSD (ORTHODONTIST/OWNER)
(812) 887-1960
Entity
Organization
Contact information
Practice address
1201 SE 223RD AVE STE 220, GRESHAM, OR 97030-2578
(503) 489-4546
Mailing address
1720 N. OLD BRUCEVILLE RD., VINCENNES, IN 47591
(812) 887-1960
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
09/24/2019
Last updated
09/24/2019
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