| NPI | 1184772774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN I GRAY President 859-498-6204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KY 4210) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2022-10-28 |