Individual
DR. CECIL BAXTER BRAY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2 LESTER CT, STATESBORO, GA 30458-2118
(912) 489-1386
(912) 764-8533
Mailing address
715 NORTHSIDE DR E, SUITE 5, PMB #395, STATESBORO, GA 30458-4712
(912) 489-1386
(912) 764-8533
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9793
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00328622B
—
GA
Enumeration date
03/21/2008
Last updated
03/21/2008
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