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General NPI Number Information
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NPI Number | 1710029293
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Entity Type | Individual
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Provider Name | DAVID BRAY D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 18 LEROY ST
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City | BINGHAMTON
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State | NY
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Zip | 13905-4603
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Country | US
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Telephone | 607-723-8377
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Fax | 607-722-1059
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Provider Business Mailing Address
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Address Line | 74 CRARY AVE
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City | BINGHAMTON
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State | NY
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Zip | 13905-3830
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 048942
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License Number State | NY
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