Provider Demographics
NPI:1295831121
Name:MCGREGOR, MICHAEL LADD (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LADD
Last Name:MCGREGOR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2785 N ANKENY BLVD
Mailing Address - Street 2:SUITE 26
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-4769
Mailing Address - Country:US
Mailing Address - Phone:515-965-5999
Mailing Address - Fax:515-965-5832
Practice Address - Street 1:2785 N ANKENY BLVD
Practice Address - Street 2:SUITE 26
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-4769
Practice Address - Country:US
Practice Address - Phone:515-965-5999
Practice Address - Fax:515-965-5832
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA060981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0124131Medicaid