Organization
DR. GREGORY LEE DERRY D.D.S. LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY LEE DERRY D.D.S. (OWNER)
(309) 647-2244
Entity
Organization
Contact information
Practice address
75 E BIRCH ST, CANTON, IL 61520-1300
(309) 647-2244
Mailing address
75 E BIRCH ST, CANTON, IL 61520-1300
(309) 647-2244
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1916263
IL
Other
Enumeration date
10/25/2007
Last updated
10/25/2007
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