Provider Demographics
NPI:1326590365
Name:MCGORRY, CLARE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CLARE
Middle Name:
Last Name:MCGORRY
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 1:1145 19TH ST NW STE 316
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-3717
Mailing Address - Country:US
Mailing Address - Phone:202-833-8240
Mailing Address - Fax:202-331-7803
Practice Address - Street 1:1145 19TH ST NW STE 316
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-3717
Practice Address - Country:US
Practice Address - Phone:202-833-8240
Practice Address - Fax:202-331-7803
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-25
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN10017231223G0001X, 122300000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies