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Individual

SANDRA D GRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
444 WILLIAM ST, EAST ORANGE, NJ 07017-2213
(973) 675-1900
(973) 675-4021
Mailing address
61 PARKSIDE DR, BELLEVILLE, NJ 07109-1602

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22D101572500
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1194996645
444 WILLIAM STREET
NJ
05
1836706
NJ
Enumeration date
12/12/2006
Last updated
06/03/2008
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