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Contact Information

BRAY, DMD & YOUNG, DMD, PC
2 LESTER CT
STATESBORO, GA30458-2118
 Phone: 912-489-1386
 Fax: 912-764-8533
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
 

Pediatric Dentistry

1223P0221X
Indicates primary specialty

NPI Profile & details for BRAY, DMD & YOUNG, DMD, PC

NPI # 1134235609
LBN Legal business name BRAY, DMD & YOUNG, DMD, PC
Authorized official CECIL BRAY - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 08/21/2006
Last updated 11/06/2007 - About 19 years ago
Identifiers
GA License # 10099
GA License # 9793
GA Medicaid 00328314B
GA Medicaid 00328622B
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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