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Individual

DR. EDWARD JOHN GRAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD, MD

Contact information

Practice address
1516 VIRGINIA RANCH RD STE 1A, GARDNERVILLE, NV 89410-5764
(775) 782-6491
(775) 782-6492
Mailing address
1516 VIRGINIA RANCH RD STE 1A, GARDNERVILLE, NV 89410-5764
(775) 782-6491
(775) 782-6492

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
S2-34
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
900024470
TAX ID
NV
Enumeration date
08/30/2006
Last updated
07/08/2007
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