Provider Demographics
NPI:1225353485
Name:HARRIS, RAYFORD J (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAYFORD
Middle Name:J
Last Name:HARRIS
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 1:701 N 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MS
Mailing Address - Zip Code:39440-3348
Mailing Address - Country:US
Mailing Address - Phone:601-649-3344
Mailing Address - Fax:601-649-3346
Practice Address - Street 1:701 N 16TH AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MS
Practice Address - Zip Code:39440-3348
Practice Address - Country:US
Practice Address - Phone:601-649-3344
Practice Address - Fax:601-649-3346
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS151972122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist