Provider Demographics
NPI:1023859519
Name:BELL, GRAYSON EVAN (DDS)
Entity type:Individual
Prefix:DR
First Name:GRAYSON
Middle Name:EVAN
Last Name:BELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1371 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-3451
Mailing Address - Country:US
Mailing Address - Phone:850-934-8222
Mailing Address - Fax:850-934-8219
Practice Address - Street 1:1371 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-3451
Practice Address - Country:US
Practice Address - Phone:850-934-8222
Practice Address - Fax:850-934-8219
Is Sole Proprietor?:No
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN286891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice