Individual
PETER B GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
143 ALLEN STREET, RUTLAND, VT 05701
(802) 773-4466
(802) 773-4644
Mailing address
143 ALLEN STREET, RUTLAND, VT 05701
(802) 773-4466
(802) 773-4644
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0160001202
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19224
BLUE CROSS
VT
01
—
9108263
CIGNA
VT
05
—
OVN0659
—
VT
Enumeration date
10/24/2006
Last updated
07/08/2007
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