Individual
GREGORY TRANDON LEE JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
865 OILFIELD AVE, SHELBY, MT 59474-2702
(406) 434-3142
Mailing address
222 AUSTIN POINT DR, WASHINGTON, NC 27889-5603
(910) 624-6765
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
25964
MT
Other
Enumeration date
08/04/2022
Last updated
08/24/2023
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