Provider Demographics
NPI:1457359481
Name:SEAL, DARRELL GREG (DDS)
Entity type:Individual
Prefix:DR
First Name:DARRELL
Middle Name:GREG
Last Name:SEAL
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 1:6010 SHERRY LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-6401
Mailing Address - Country:US
Mailing Address - Phone:214-361-0883
Mailing Address - Fax:214-361-2706
Practice Address - Street 1:6010 SHERRY LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-6401
Practice Address - Country:US
Practice Address - Phone:214-361-0883
Practice Address - Fax:214-361-2706
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX169941223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics