Provider Demographics
NPI:1467292649
Name:GRAY, JOSHUA MORRIS (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:MORRIS
Last Name:GRAY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 CUMBERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BARBOURVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40906-1204
Mailing Address - Country:US
Mailing Address - Phone:606-546-3660
Mailing Address - Fax:
Practice Address - Street 1:240 CUMBERLAND AVE
Practice Address - Street 2:
Practice Address - City:BARBOURVILLE
Practice Address - State:KY
Practice Address - Zip Code:40906-1204
Practice Address - Country:US
Practice Address - Phone:606-627-0371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY11124122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist