Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 42042 | CA |
NPI | 1003924531 |
---|---|
Provider Name | Gregory J Conte |
First Address | San Francisco, CA 94127-1429 |
Second Address | San Francisco, CA 94127-1429 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2006 |
Last Update Date | 08/07/2007 |