Healthcare Provider Details

I. General information

NPI: 1265523146
Provider Name (Legal Business Name): JOSEPH D. OPRAY DMD,PC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 NE COXLEY DR
VANCOUVER WA
98662-6193
US

IV. Provider business mailing address

11100 NE COXLEY DR
VANCOUVER WA
98662-6193
US

V. Phone/Fax

Practice location:
  • Phone: 360-254-9700
  • Fax: 360-254-5580
Mailing address:
  • Phone: 360-254-9700
  • Fax: 360-254-5580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5528
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: