Provider Demographics
NPI:1669682589
Name:MCGREGOR, ELIZABETH N (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:N
Last Name:MCGREGOR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 17179
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92623-7179
Mailing Address - Country:US
Mailing Address - Phone:949-567-3176
Mailing Address - Fax:949-567-3185
Practice Address - Street 1:12800 HEACOCK ST
Practice Address - Street 2:A-1
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-2853
Practice Address - Country:US
Practice Address - Phone:951-247-2688
Practice Address - Fax:951-247-3142
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA472861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice