Individual
DR. MICHAEL KEESEE GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
669 MONROE AVE, FORT EUSTIS, VA 23604-5005
(757) 878-3434
Mailing address
669 MONROE AVE, FORT EUSTIS, VA 23604-5005
(757) 878-3434
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401008282
VA
1223G0001X
General Practice Dentistry
Primary
DS 4120
TN
Other
Enumeration date
10/31/2006
Last updated
10/14/2010
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