Healthcare Provider Details

I. General information

NPI: 1699951236
Provider Name (Legal Business Name): GARY S MAY DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2008
Last Update Date: 01/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 SHORRTCUT RD 290 OX
INCHELIUM WA
99138
US

IV. Provider business mailing address

PO BOX 334 3052 BRIDGECREEK RD
INCHELIUM WA
99138-0334
US

V. Phone/Fax

Practice location:
  • Phone: 509-722-7014
  • Fax:
Mailing address:
  • Phone: 509-592-3051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number33249
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: