Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 53507 | CA |
NPI | 1346568789 |
---|---|
Provider Name | Dr. Don Gregg |
First Address | Redlands, CA 92373-4858 |
Second Address | Loma Linda, CA 92350-1706 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2010 |
Last Update Date | 10/05/2010 |