Provider Demographics
NPI:1629229273
Name:GARY J. MAY, DMD, MSD, PC
Entity Type:Organization
Organization Name:GARY J. MAY, DMD, MSD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MSD
Authorized Official - Phone:541-779-3003
Mailing Address - Street 1:1625 E MCANDREWS RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-5334
Mailing Address - Country:US
Mailing Address - Phone:541-779-3003
Mailing Address - Fax:541-779-3093
Practice Address - Street 1:1625 E MCANDREWS RD
Practice Address - Street 2:SUITE B
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-5334
Practice Address - Country:US
Practice Address - Phone:541-779-3003
Practice Address - Fax:541-779-3093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD58571223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty