Healthcare Provider Details

I. General information

NPI: 1013834753
Provider Name (Legal Business Name): SARA KNIGHTON GRAY DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 N PARRISH AVE
ADEL GA
31620-2062
US

IV. Provider business mailing address

602 N PARRISH AVE
ADEL GA
31620-2062
US

V. Phone/Fax

Practice location:
  • Phone: 229-292-1560
  • Fax:
Mailing address:
  • Phone: 229-292-1560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN124202
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: