National Provider Identifier

Michael Yldemar Gray SR.

Michael Yldemar Gray SR. is listed in the NPPES registry with a primary specialty of Dentist in Webster, NY and a listed phone number of (585) 866-1786.

NPI 1689384836Webster, NYDentist

Profile Overview

NPI
1689384836
Provider Type
Individual
Primary Specialty
Dentist
Enumeration Date
November 29, 2022
Last Updated
July 25, 2024

Practice Location

  • 1674 Empire Blvd
  • Webster, NY 14580-1894

Phone: (585) 866-1786

Mailing Address

  • 580A Quincy St
  • Brooklyn, NY 11221-8049

Specialties

  • Dentist (122300000X)
  • Dentist (122300000X)
  • Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
NPI
1689384836
Entity Type
Individual
Last Name
Gray
First Name
Michael
Middle Name
Yldemar
Name Prefix
Dr.
Name Suffix
SR.
Mailing Street Address
580A Quincy St
Mailing City
Brooklyn
Mailing State
NY
Mailing ZIP Code
11221-8049
Mailing Country
US
Mailing Phone
(917) 756-9584
Practice Street Address
1674 Empire Blvd
Practice City
Webster
Practice State
NY
Practice ZIP Code
14580-1894
Practice Country
US
Practice Phone
(585) 866-1786
Enumeration Date
November 29, 2022
Last Updated
July 25, 2024
Sex
Male
Sole Proprietor
No
Certification Date
July 25, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Dentist (122300000X), Dentist (122300000X), Student in an Organized Health Care Education/Training Program (390200000X)