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General NPI Number Information
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NPI Number | 1477048098
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Entity Type | Individual
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Provider Name | ASHLEIGH NICOLE GRALEY DDS
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Gender | Female
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Dates
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Enumeration Date | 06/26/2018
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Last Update Date | 06/26/2018
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Provider Practice Location Address
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Address Line | 36 BRIDGE WAY
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City | PASCOAG
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State | RI
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Zip | 02859-3131
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Country | US
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Telephone | 401-285-5119
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Fax |
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Provider Business Mailing Address
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Address Line | 166 VALLEY ST APT 6M314
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City | PROVIDENCE
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State | RI
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Zip | 02909-2481
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Country | US
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Telephone | 304-276-8863
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DEN03398
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License Number State | RI
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