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Individual
SANDRA D GRAY
Active
Individual
SANDRA D GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22D101572500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194996645
444 WILLIAM STREET
NJ
05
—
1836706
—
NJ
Enumeration date
12/12/2006
Last updated
06/03/2008
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