Healthcare Provider Details

I. General information

NPI: 1174353940
Provider Name (Legal Business Name): GREGORY DOWSE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2024
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 DEFENSE PENTAGON
WASHINGTON DC
20310-0001
US

IV. Provider business mailing address

1800 N CAPITOL ST NW # B
WASHINGTON DC
20002-1502
US

V. Phone/Fax

Practice location:
  • Phone: 703-692-8810
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number14089266-9926
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: