Individual
MR. JERRY WAYNE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDH
Contact information
Practice address
6601 S RURAL RD, TEMPE, AZ 85283-3747
(480) 456-0821
Mailing address
6601 S RURAL RD, TEMPE, AZ 85283-3747
(480) 456-0821
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
4544
AZ
Other
Enumeration date
09/24/2010
Last updated
10/15/2010
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