MEDICARE: DR. DONALD W RAY II D.M.D.

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	1223G0001X	General Practice Dentistry	DS027383-L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	619983	OTHER	PA	UNITED CONCORDIA PROVIDER

General Provider Information

NPI Number	:	1770503781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD W RAY II D.M.D.

Provider Business Mailing Address
First Line	:	432 FRYE FARM RD
Second Line	:
City	:	GREENSBURG
State	:	PA
Zip	:	15601-6480
Country	:	US
Telephone Number	:	724-537-0800
Fax Number	:	724-537-0904

Provider Business Practice Location Address
First Line	:	432 FRYE FARM RD
Second Line	:
City	:	GREENSBURG
State	:	PA
Zip	:	15601-6480
Country	:	US
Telephone Number	:	724-537-0800
Fax Number	:	724-537-0904

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	07/08/2007

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