Provider Demographics
NPI:1326176587
Name:RAY, LAWRENCE KENT (DMD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:KENT
Last Name:RAY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9291 HIGHWAY 23
Mailing Address - Street 2:UNIT # 13
Mailing Address - City:NEW TOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58763-9442
Mailing Address - Country:US
Mailing Address - Phone:701-627-7825
Mailing Address - Fax:701-627-3907
Practice Address - Street 1:1 MINNI TOHE DR
Practice Address - Street 2:
Practice Address - City:NEW TOWN
Practice Address - State:ND
Practice Address - Zip Code:58763-4400
Practice Address - Country:US
Practice Address - Phone:701-627-7920
Practice Address - Fax:701-627-3907
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1824122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist