Organization
JESSE R GRAY DDS PA
Active
Organization
JESSE R GRAY DDS PA
Active
Other names
Northwest Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESS R GRAY DDS (OWNER)
(479) 521-4181
Entity
Organization
Contact information
Practice address
3119 E MISSION BLVD, FAYETTEVILLE, AR 72703-6617
(479) 521-4181
(479) 521-0442
Mailing address
3119 E MISSION BLVD, FAYETTEVILLE, AR 72703-6617
(479) 521-4181
(479) 521-0442
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3427
AR
Other
Enumeration date
02/09/2017
Last updated
02/09/2017
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