Provider Demographics
NPI:1154811487
Name:MCGREGOR, EBEN L (DDS)
Entity type:Individual
Prefix:DR
First Name:EBEN
Middle Name:L
Last Name:MCGREGOR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2031 KENTWELL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-1905
Mailing Address - Country:US
Mailing Address - Phone:513-314-4077
Mailing Address - Fax:513-314-4077
Practice Address - Street 1:44 XENIA TOWNE SQ
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-2931
Practice Address - Country:US
Practice Address - Phone:937-410-0451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-11
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.025425122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist