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Individual

KENDRICK DORON GRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
1701 E THOMAS RD, SUITE 204, PHOENIX, AZ 85016-7646
(602) 253-6600
Mailing address
1611 S 173RD DR, GOODYEAR, AZ 85338-1951
(623) 882-8348

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D5504
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
232643
AZ
Enumeration date
07/03/2007
Last updated
11/06/2012
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