Provider Demographics
NPI:1508081738
Name:DAMRON, GREGORY F (DDS)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:F
Last Name:DAMRON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3318 PEACHWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2211
Mailing Address - Country:US
Mailing Address - Phone:281-265-5503
Mailing Address - Fax:
Practice Address - Street 1:15510 LEXINGTON BLVD STE K
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4173
Practice Address - Country:US
Practice Address - Phone:281-265-2950
Practice Address - Fax:281-265-5741
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX138561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice