| NPI | 1952054793 |
|---|---|
| Former Legal Business Name | GRAY'S PERIODONTAL CENTER, PC |
| Entity Type | Organization |
| Authorized Contact | ANDREW GRAY CEO 757-716-3539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-02-01 |
| Last Update Date | 2022-02-01 |