# JOHN I. GRAY, III, PSC

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

## Provider details

- **NPI number:** 1790763258
- **Authorized official:** DR. JOHN I GRAY III DMD (OWNER)
- **Authorized official phone:** (859) 744-0677

## Contact information

- **Practice address:** 1303 W LEXINGTON AVE, WINCHESTER, KY 40391-3100
- **Practice address phone:** (859) 744-0677
- **Practice address fax:** (859) 745-4466
- **Mailing address:** 1303 W LEXINGTON AVE, WINCHESTER, KY 40391-3100
- **Mailing address phone:** (859) 744-0677
- **Mailing address fax:** (859) 745-4466

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 4210 | KY | Yes |

## Other

- **Enumeration date:** 01/05/2006
- **Last updated:** 11/22/2022