Gray, Jonathan Russell

Gray, Jonathan Russell is an individual health care provider with primary practice located at 4344 20Th Ave S , Fargo ND 58103-7436. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Gray, Jonathan Russell can be contacted via phone (701) 239-5969.

Contact Information

Primary practice address
4344 20Th Ave S Fargo ND 58103-7436
Phone: (701) 239-5969
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 2096 North Dakota

Profile Details

NPI number 1508048521
LBN Legal business name Gray, Jonathan Russell
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2007
Last updated Aug 19th, 2011 - about 13 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.

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