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General NPI Number Information
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NPI Number | 1710222021
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Entity Type | Organization
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Legal Business Name | BRIAN D. RAY DMD
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Dates
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Enumeration Date | 11/28/2012
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Last Update Date | 11/28/2012
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Provider Practice Location Address
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Address Line | 1256 BOILING SPRINGS ROAD
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City | SPARTANBURG
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State | SC
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Zip | 29303
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Country | US
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Telephone | 864-582-6306
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Fax | 864-585-9593
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Provider Business Mailing Address
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Address Line | 1256 BOILING SPRINGS ROAD
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City | SPARTANBURG
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State | SC
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Zip | 29303
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Country | US
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Telephone | 864-582-6306
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Fax | 864-585-9593
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Authorized Official
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Title or Position | OFFICE
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Name | MRS. CAROLYN PARRIS
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Credential |
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Telephone | 864-582-6306
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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 |
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License Number State | SC
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