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General NPI Number Information
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NPI Number | 1578780029
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Entity Type | Organization
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Legal Business Name | RAY ORTHODONITCS INC
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 683 COOPER ROAD
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City | WESTERVILLE
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State | OH
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Zip | 43081-8962
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Country | US
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Telephone | 614-882-1185
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Fax | 614-882-0621
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Provider Business Mailing Address
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Address Line | 683 COOPER ROAD
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City | WESTERVILLE
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State | OH
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Zip | 43081-8962
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Country | US
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Telephone | 614-882-1185
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Fax | 614-882-0621
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Authorized Official
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Title or Position | DDS, MS
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Name | DR. DAVID A, RAY
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Credential | DDS, MS
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Telephone | 614-882-1185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 30017407
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License Number State | OH
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