NPI 1194174904

Mark Gregory Gray, DDS

Practitioner Dentist Bridgeport, WV

Practice location

Address: 200 Orchard Ave, Bridgeport, WV 26330-1737
Phone: (304) 657-8324

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 4211 (WV)

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Registry record

NPI: 1194174904
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Jun 2016
Record last updated: 13 Jun 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.