MEDICARE: JOSH C RAY DMD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	4345	SC

General Provider Information

NPI Number	:	1083153118
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSH C RAY DMD PA

Provider Business Mailing Address
First Line	:	2131 WOODRUFF RD
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29607-5950
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2131 WOODRUFF RD
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29607-5950
Country	:	US
Telephone Number	:	864-804-9864
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOSH CRAIG RAY
Credential	:	DMD
Telephone Number	:	864-804-9864

Provider Enumeration Date	:	02/22/2017
Last Update Date	:	02/22/2017

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Directions to “JOSH C RAY DMD PA ” Practice Location

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