| NPI | 1790763258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN I GRAY Owner 859-744-0677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: KY 4210) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2022-11-22 |