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Individual

DR. EDWARD WYATT GRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1776 GRAND AVENUE, SAN DIEGO, CA 92109
(858) 270-7540
(858) 270-3428
Mailing address
1776 GRAND AVENUE, SAN DIEGO, CA 92109
(858) 270-7540
(858) 270-3428

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
31272
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DD031272
DEPT OF CONSUMER AFFAIRS
CA
Enumeration date
08/30/2006
Last updated
03/07/2023
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