Dr. Gregory Lee Derry D.d.s. Ltd

NPI #1952580094 in Canton, Illinois

Provider Information

NPI Number: 1952580094
Entity Type: Organization
Organization Name: Dr. Gregory Lee Derry D.d.s. Ltd
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 25, 2007
Last Updated: Oct 25, 2007

Practice Location

Address: 75 E BIRCH ST
City: Canton
State: Illinois
ZIP Code: 61520-1300
Phone: (309) 647-2244

Authorized Official

Name: DR. GREGORY LEE DERRY, D.D.S.
Title: OWNER
Phone: (309) 647-2244

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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