Bray, Gordon Warren
Bray, Gordon Warren is an sole proprietor health care provider with primary practice located at 1376 Cleveland St , Greenville SC 29607-2435. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Bray, Gordon Warren can be contacted via phone (864) 250-1100.Contact Information
Primary practice address
1376 Cleveland St
Greenville SC 29607-2435
Phone: (864) 250-1100
Fax: (864) 250-1604
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Dental Providers / Pediatric Dentistry | 1223P0221X | 252 | South Carolina |
Profile Details
NPI number | 1164503710 |
---|---|
LBN Legal business name | Bray, Gordon Warren |
Credentials | Doctor of Dental Medicine (DMD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Oct 18th, 2006 |
Last updated | May 13th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1164503710 | NPPES |
South Carolina | MEDICAID | 433103 |
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