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General NPI Number Information
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NPI Number | 1477023778
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Entity Type | Organization
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Legal Business Name | GREGORY MCGEE, DMD
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Dates
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Enumeration Date | 11/29/2018
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Last Update Date | 07/24/2019
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Provider Practice Location Address
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Address Line | 3905 WASHINGTON PKWY
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City | IDAHO FALLS
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State | ID
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Zip | 83404-7596
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Country | US
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Telephone | 208-528-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 2184 CHANNING WAY STE 229
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City | IDAHO FALLS
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State | ID
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Zip | 83404-8034
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Country | US
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Telephone | 505-205-6618
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GREGORY MCGEE
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Credential | DMD
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Telephone | 208-521-1891
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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