Individual
MR. GREGORY ALAN MADRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS PC
Contact information
Practice address
107 WEST CHERRY ST, JESUP, GA 31545
(912) 427-6404
(912) 427-8628
Mailing address
107 WEST CHERRY ST, JESUP, GA 31545
(912) 427-6404
(912) 427-8628
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10343
GA
122300000X
Dentist
10343 GA
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00325619D
—
GA
Enumeration date
08/21/2006
Last updated
07/08/2007
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