Organization
ANITA A GRAY DDS PA PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY R BATES DMD (OWNER/DENTIST)
(859) 745-4455
Entity
Organization
Contact information
Practice address
1303 W LEXINGTON AVE, SUITE A, WINCHESTER, KY 40391-3100
(859) 745-4455
(859) 745-4466
Mailing address
1303 W LEXINGTON AVE, SUITE A, WINCHESTER, KY 40391-3100
(859) 745-4455
(859) 745-4466
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5077
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100179950
—
KY
Enumeration date
09/30/2011
Last updated
10/10/2016
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