Individual
JESSIE GREGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
968 1ST INFANTRY DIVISION RD, FORT KNOX, KY 40121-5210
(502) 626-8303
Mailing address
CMR 414 BOX 1304, APO, AE 09173-0014
(931) 217-8253
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10748
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
359990000
US ARMY
TN
Enumeration date
08/09/2018
Last updated
01/01/2024
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