Provider Demographics
NPI:1952393423
Name:GREGSON, NORMAN DEAN (DMD PC)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:DEAN
Last Name:GREGSON
Suffix:
Gender:M
Credentials:DMD PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18455 SE MCLOUGHLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97267-6459
Mailing Address - Country:US
Mailing Address - Phone:503-659-1991
Mailing Address - Fax:503-659-0114
Practice Address - Street 1:18455 SE MCLOUGHLIN BLVD
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97267-6459
Practice Address - Country:US
Practice Address - Phone:503-659-1991
Practice Address - Fax:503-659-0114
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR70901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice