Individual
JOSHUA PRICE WRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
150 S MAIN ST, MALAD CITY, ID 83252-1405
(208) 905-3614
Mailing address
150 S MAIN ST, MALAD CITY, ID 83252-1405
(208) 905-3614
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-5426
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D-5462
LICENSE NUMBER
ID
Enumeration date
06/14/2022
Last updated
06/14/2022
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