Organization
GRAY TEAM LLC
Active
Other names
Parkway Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TYSON GRAY D.M.D (OWNER)
(208) 342-4644
Entity
Organization
Contact information
Practice address
813 N STILSON RD, STE:B, BOISE, ID 83703-5119
(208) 342-4644
(208) 367-0283
Mailing address
813 N STILSON RD, STE:B, BOISE, ID 83703-5119
(208) 342-4644
(208) 367-0283
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/17/2015
Last updated
06/30/2015
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