# ANITA A GRAY DDS PA PSC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710261383
- **Authorized official:** DR. KIMBERLY R BATES DMD (OWNER/DENTIST)
- **Authorized official phone:** (859) 745-4455

## Contact information

- **Practice address:** 1303 W LEXINGTON AVE, SUITE A, WINCHESTER, KY 40391-3100
- **Practice address phone:** (859) 745-4455
- **Practice address fax:** (859) 745-4466
- **Mailing address:** 1303 W LEXINGTON AVE, SUITE A, WINCHESTER, KY 40391-3100
- **Mailing address phone:** (859) 745-4455
- **Mailing address fax:** (859) 745-4466

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5077 | KY | Yes |

## Other

- **Enumeration date:** 09/30/2011
- **Last updated:** 10/10/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7100179950 | — | KY |