Individual
DR. WALTER M. GRAYSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3640 CHAMBLEE TUCKER RD, CHAMBLEE, GA 30341-4418
(770) 938-0232
Mailing address
2027 SPRINGVIEW TRL, TUCKER, GA 30084-2448
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8862
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1881323
UNITED CONCORDIA ID
GA
Enumeration date
05/16/2007
Last updated
07/08/2007
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