Individual
DR. DOMINICQUE BLANCHE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
3946 MINNESOTA AVE NE, WASHINGTON, DC 20019-2661
(202) 397-1033
Mailing address
3946 MINNESOTA AVE NE, WASHINGTON, DC 20019-2661
(202) 397-1033
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1001106
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
059525000
—
DC
Enumeration date
07/08/2011
Last updated
10/31/2016
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