Provider Demographics
NPI:1497757033
Name:GRAY, WILLIAM ALDEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ALDEN
Last Name:GRAY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 S ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-4218
Mailing Address - Country:US
Mailing Address - Phone:405-372-5588
Mailing Address - Fax:405-624-3221
Practice Address - Street 1:605 S ORCHARD ST
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-4218
Practice Address - Country:US
Practice Address - Phone:405-372-5588
Practice Address - Fax:405-624-3221
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK31591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice