Organization
ANGELA GRAY FAMILY DENTISTRY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELA HOWARD GRAY D.D.S. (DENTIST)
(501) 382-4729
Entity
Organization
Contact information
Practice address
2650 JOHN HARDEN DR, JACKSONVILLE, AR 72076-1819
(501) 982-4729
Mailing address
2650 JOHN HARDEN DR, JACKSONVILLE, AR 72076-1819
(501) 982-4729
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3482
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172956631
—
AR
Enumeration date
01/08/2009
Last updated
01/08/2009
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