Individual
JEFFREY R GRAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
237 W MULBERRY, OGDEN, IA 50212-0813
(515) 275-2250
(515) 275-2816
Mailing address
237 W MULBERRY, OGDEN, IA 50212-0813
(515) 275-2250
(515) 275-2816
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
08240
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0449629
—
IA
Enumeration date
02/28/2007
Last updated
07/08/2007
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