| Anita A Gray Dds Pa Psc | |
|
1303 W Lexington Ave Suite A Winchester KY 40391-3100 | |
| (859) 745-4455 | |
| (859) 745-4466 |
| Full Name | Anita A Gray Dds Pa Psc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1303 W Lexington Ave, Winchester, Kentucky |
| Authorized Official Name and Position | Kimberly R Bates (OWNER/DENTIST) |
| Authorized Official Contact | 8597454455 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Anita A Gray Dds Pa Psc 1303 W Lexington Ave Suite A Winchester KY 40391-3100 Ph: (859) 745-4455 | Anita A Gray Dds Pa Psc 1303 W Lexington Ave Suite A Winchester KY 40391-3100 Ph: (859) 745-4455 |
| NPI Number | 1710261383 |
|---|---|
| Provider Enumeration Date | 09/30/2011 |
| Last Update Date | 10/10/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710261383 | NPI | - | NPPES |
| 7100179950 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5077 (Kentucky) | Primary |
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