Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DEN1001584 | DC |
NPI | 1003262940 |
---|---|
Provider Name | Dr. Darnell Gregory |
First Address | Washington, DC 20012-1324 |
Second Address | Washington, DC 20012-1324 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2016 |
Last Update Date | 10/05/2016 |