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Contact Information

ANGELA GRAY FAMILY DENTISTRY INC.
2650 JOHN HARDEN DR
JACKSONVILLE, AR72076-1819
 Phone: 501-982-4729
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for ANGELA GRAY FAMILY DENTISTRY INC.

NPI Number 1629215983
LBN Legal business name ANGELA GRAY FAMILY DENTISTRY INC.
Authorized official ANGELA GRAY - (DENTIST)
Entity Organization
Organization subpart 1 No
Enumeration date 01/08/2009
Last updated 01/08/2009 - About 17 years ago
Identifiers
AR License # 3482
AR Medicaid 172956631
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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