Del Gene Gregory, D.D.S.
Individual provider Active NPI General Practice Dentistry · Macon, MO
NPI 1164645560 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1164645560
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DE015840 (MO)
- Practice address
- 1609 Maffry Ave
Macon, MO 63552-1960 - Phone
- (660) 385-3413
- Fax
- (660) 385-7069
- NPI assigned
- Apr 11, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE015840 | MO | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Long Branch Dental Group, del G. Gregory, D.D.S., PC | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DE015840 | MO | Yes |
Addresses
Primary practice location
1609 Maffry Ave
Macon, MO 63552-1960
Mailing address
1609 Maffry Ave
Macon, MO 63552-1960
Phone (660) 385-3413
Other providers in Macon, MO
- Bradley Robert Freidel
- Christopher A Froman
- Iris Ladawn Gaerditz
- Lucy Gaston
- Laurie Gilchrist
- Hannah Grigsby
- Brooksy Lee Halterman
- Adrienne Mignon Hatcher
- Health and Healing LLC
- Nora Marie Hockman-McDowell
All providers in Macon, MO · General Practice Dentistry in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.