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Individual

DENNIS D BRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
100 HOSPITAL DR, LEBANON, MO 65536-9210
(800) 277-8151
(336) 841-6217
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
087809
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
919780601
MO
Enumeration date
05/31/2005
Last updated
10/10/2011
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