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General NPI Number Information
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NPI Number | 1710145222
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Entity Type | Individual
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Provider Name | JOSEPH ADAM GREGORICH DDS
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Gender | Male
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Dates
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Enumeration Date | 05/30/2008
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Last Update Date | 05/30/2008
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Provider Practice Location Address
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Address Line | 601 HIGHWAY 73 BOX 46
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City | FLOODWOOD
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State | MN
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Zip | 55736
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Country | US
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Telephone | 218-476-2969
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Fax |
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Provider Business Mailing Address
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Address Line | 1819 YOSEMITE AVE
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City | DULUTH
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State | MN
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Zip | 55811-1901
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Country | US
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Telephone | 218-349-5586
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D12516
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License Number State | MN
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