Provider Demographics
NPI:1093726051
Name:KITCHENS, GEORGE GRAY JR (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:GRAY
Last Name:KITCHENS
Suffix:JR
Gender:M
Credentials:DMD, MS
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:2 LAFAY WAY
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-3784
Mailing Address - Country:US
Mailing Address - Phone:864-322-2469
Mailing Address - Fax:864-322-2469
Practice Address - Street 1:303 E HIGHLAND AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-4767
Practice Address - Country:US
Practice Address - Phone:864-225-6607
Practice Address - Fax:864-225-6177
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC40911223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics