Organization
JOHN I. GRAY, III, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN I GRAY III DMD (OWNER)
(859) 744-0677
Entity
Organization
Contact information
Practice address
1303 W LEXINGTON AVE, WINCHESTER, KY 40391-3100
(859) 744-0677
(859) 745-4466
Mailing address
1303 W LEXINGTON AVE, WINCHESTER, KY 40391-3100
(859) 744-0677
(859) 745-4466
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4210
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60042108
—
KY
05
—
61941274
—
KY
05
—
64042104
—
KY
05
—
65911885
—
KY
Enumeration date
01/05/2006
Last updated
11/22/2022
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