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General NPI Number Information
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NPI Number | 1932674108
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Entity Type | Organization
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Legal Business Name | A. W. RAY DDS MD LLC
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Dates
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Enumeration Date | 10/03/2018
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Last Update Date | 10/03/2018
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Provider Practice Location Address
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Address Line | 928 W CHANDLER BLVD STE D-2
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City | CHANDLER
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State | AZ
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Zip | 85225-4900
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Country | US
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Telephone | 480-899-8893
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Fax |
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Provider Business Mailing Address
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Address Line | 928 W CHANDLER BLVD STE D-2
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City | CHANDLER
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State | AZ
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Zip | 85225-4900
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Country | US
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Telephone | 480-899-8893
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Fax |
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Authorized Official
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Title or Position | ORAL SURGEON
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Name | DR. ANDREW RAY
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Credential | DDS, MD
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Telephone | 480-899-8893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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