# WILLIAM A. GRAY, D.M.D., LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** St. Louis South Oral Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336365956
- **Authorized official:** DANA M POPPE (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (314) 842-4699

## Contact information

- **Practice address:** 9911 KENNERLY RD, SUITE E, SAINT LOUIS, MO 63128-2700
- **Practice address phone:** (314) 842-4699
- **Practice address fax:** (314) 842-3074
- **Mailing address:** 9911 KENNERLY RD, SUITE E, SAINT LOUIS, MO 63128-2700
- **Mailing address phone:** (314) 842-4699
- **Mailing address fax:** (314) 842-3074

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 04/18/2007
- **Last updated:** 06/30/2023