Organization
JOHN I GRAY III PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN I GRAY III DMD (PRESIDENT)
(859) 498-6204
Entity
Organization
Contact information
Practice address
25 E HIGH ST, MT STERLING, KY 40353-1267
(859) 498-6204
(859) 498-6205
Mailing address
25 E HIGH ST, MT STERLING, KY 40353-1267
(859) 498-6204
(859) 498-6205
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4210
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60002284
—
KY
05
—
60038353
—
KY
05
—
61941258
—
KY
05
—
64180185
—
KY
05
—
64942584
—
KY
05
—
65911877
—
KY
Enumeration date
01/08/2007
Last updated
10/28/2022
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