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General NPI Number Information
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NPI Number | 1124146600
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Entity Type | Individual
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Provider Name | LARRY HARRISON RAY DDS
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Gender | Male
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 831 W MORGAN ST 4278 MSC
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City | RALEIGH
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State | NC
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Zip | 27699-4278
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Country | US
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Telephone | 919-838-3855
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Fax | 919-733-1415
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Provider Business Mailing Address
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Address Line | 7021 STONY HILL RD
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City | WAKE FOREST
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State | NC
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Zip | 27587-7341
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Country | US
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Telephone | 919-556-5419
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4939
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License Number State | NC
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