Individual
DR. JILL LAVONNE GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
201 S 8TH ST, MARYSVILLE, KS 66508-1907
(785) 562-5323
(844) 270-3105
Mailing address
201 S 8TH ST, MARYSVILLE, KS 66508-1907
(785) 562-5323
(844) 270-3105
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
KS 60212
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00001747982
TRICARE
KS
01
—
0000421758
BCBS
KS
05
—
200328140A
—
KS
Enumeration date
03/09/2006
Last updated
06/18/2024
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