Provider Demographics
NPI:1205885936
Name:GRAY, PHILLIP II (DDS)
Entity type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:
Last Name:GRAY
Suffix:II
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 1:625 BERRY RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-2826
Mailing Address - Country:US
Mailing Address - Phone:615-385-9400
Mailing Address - Fax:
Practice Address - Street 1:625 BERRY RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-2826
Practice Address - Country:US
Practice Address - Phone:615-385-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000077151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice