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General NPI Number Information
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NPI Number | 1649491739
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Entity Type | Individual
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Provider Name | DAVID RAY DMD
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Gender | Male
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 06/20/2019
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Provider Practice Location Address
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Address Line | 13521 OLD HIGHWAY 280 STE 229
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City | BIRMINGHAM
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State | AL
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Zip | 35242-1406
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Country | US
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Telephone | 205-739-2175
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Fax |
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Provider Business Mailing Address
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Address Line | 34011-B US HWY 280
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City | CHILDERSBURG
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State | AL
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Zip | 35044-2128
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Country | US
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Telephone |
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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 | 22DI02332500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 5804
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License Number State | AL
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