Provider Demographics
NPI:1215224688
Name:BRAY, CHARLES CASSIDY (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:CASSIDY
Last Name:BRAY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2411 PENNY RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-8122
Mailing Address - Country:US
Mailing Address - Phone:336-883-1371
Mailing Address - Fax:336-883-8158
Practice Address - Street 1:2411 PENNY RD
Practice Address - Street 2:SUITE 204
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-8122
Practice Address - Country:US
Practice Address - Phone:336-883-1371
Practice Address - Fax:336-883-8158
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9166122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist