Provider Demographics
NPI:1740307834
Name:GRAY, WILLIAM JOHN (DMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOHN
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 1:6149 SALTSBURG RD
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:PA
Mailing Address - Zip Code:15147-3542
Mailing Address - Country:US
Mailing Address - Phone:412-795-3333
Mailing Address - Fax:412-793-7080
Practice Address - Street 1:6149 SALTSBURG RD
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:PA
Practice Address - Zip Code:15147-3542
Practice Address - Country:US
Practice Address - Phone:412-795-3333
Practice Address - Fax:412-793-7080
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025027L1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics