Healthcare Provider Details

I. General information

NPI: 1811811375
Provider Name (Legal Business Name): RALEY ORTHODONTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 PEACHTREE INDUSTRIAL BLVD STE 105
SUGAR HILL GA
30518-9126
US

IV. Provider business mailing address

245 PEACHTREE INDUSTRIAL BLVD STE 105
SUGAR HILL GA
30518-9126
US

V. Phone/Fax

Practice location:
  • Phone: 770-727-4003
  • Fax:
Mailing address:
  • Phone: 770-727-4003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES RALEY
Title or Position: ORTHODONTIST
Credential: DMD
Phone: 404-323-3895