Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 051594 | NY |
N | 1223S0112X | Oral and Maxillofacial Surgeon | DN15695 | FL |
NPI | 1043425804 |
---|---|
Provider Name | Dr. David A. Macgregor |
First Address | Fulton, NY 13069 |
Second Address | Fulton, NY 13069 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 31/01/2019 |