Provider Demographics
NPI:1700379666
Name:GRAY, PRESTON FORD (DDS)
Entity Type:Individual
Prefix:DR
First Name:PRESTON
Middle Name:FORD
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 1:4918 WESTERHAM ST
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-4008
Mailing Address - Country:US
Mailing Address - Phone:281-610-1861
Mailing Address - Fax:
Practice Address - Street 1:9125 WEST RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77064-8623
Practice Address - Country:US
Practice Address - Phone:713-597-8302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34212122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist