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General NPI Number Information
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NPI Number | 1235342296
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Entity Type | Individual
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Provider Name | JAMES BURNARD GRAY D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10930 CRABAPPLE RD SUITE 240
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City | ROSWELL
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State | GA
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Zip | 30075-5813
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Country | US
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Telephone | 770-993-6292
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Fax |
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Provider Business Mailing Address
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Address Line | 10930 CRABAPPLE ROADSUITE 240 SUITE 240
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City | ROSWELL
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State | GA
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Zip | 30075-3007
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 9681
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License Number State | GA
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