J.r. Gregg LLC

NPI #1487205233 in Gresham, Oregon

Provider Information

NPI Number: 1487205233
Entity Type: Organization
Organization Name: J.r. Gregg LLC
Primary Specialty: Dentist - Orthodontics and Dentofacial Orthopedics
Enumeration Date: Sep 24, 2019
Last Updated: Sep 24, 2019

Practice Location

Address: 1201 SE 223RD AVE STE 220
City: Gresham
State: Oregon
ZIP Code: 97030-2578
Phone: (503) 489-4546

Authorized Official

Name: DR. JOSEPH RANDALL GREGG, DDS, MSD
Title: ORTHODONTIST/OWNER
Phone: (812) 887-1960

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X	Primary

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