Individual
SUSAN FLOYD GREGORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
25 MIDDLETON DR, LUGOFF, SC 29078-9553
(803) 420-1254
Mailing address
25 MIDDLETON DR, LUGOFF, SC 29078-9553
(803) 420-1254
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
13638
NC
1223G0001X
General Practice Dentistry
Primary
3769
SC
1223G0001X
General Practice Dentistry
DN123344
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZX3769
—
SC
Enumeration date
10/06/2006
Last updated
04/29/2024
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