Provider Demographics
NPI:1235282229
Name:DORAY, PAMELA GAYLE (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:GAYLE
Last Name:DORAY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1528 WALNUT ST
Mailing Address - Street 2:SUITE 1800
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-3604
Mailing Address - Country:US
Mailing Address - Phone:215-772-3100
Mailing Address - Fax:215-772-1125
Practice Address - Street 1:1528 WALNUT ST
Practice Address - Street 2:SUITE 1800
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-3604
Practice Address - Country:US
Practice Address - Phone:215-772-3100
Practice Address - Fax:215-772-1125
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS024070L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice