Provider Demographics
NPI:1003906538
Name:RICHARD J. CRAY, DMD, MSD, PA
Entity Type:Organization
Organization Name:RICHARD J. CRAY, DMD, MSD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:CRAY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MSD, PA
Authorized Official - Phone:919-467-3213
Mailing Address - Street 1:1142 EXECUTIVE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518
Mailing Address - Country:US
Mailing Address - Phone:919-467-3213
Mailing Address - Fax:919-467-3246
Practice Address - Street 1:1142 EXECUTIVE CIR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4570
Practice Address - Country:US
Practice Address - Phone:919-467-3213
Practice Address - Fax:919-467-3246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39881223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty