Provider Demographics
NPI:1386672301
Name:RAY, DANIEL WESLEY (DMD,MS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:WESLEY
Last Name:RAY
Suffix:
Gender:M
Credentials:DMD,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33364 ELK RUN
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-6843
Mailing Address - Country:US
Mailing Address - Phone:303-670-4824
Mailing Address - Fax:303-399-1081
Practice Address - Street 1:1633 FILLMORE ST
Practice Address - Street 2:SUITE 112
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-1514
Practice Address - Country:US
Practice Address - Phone:303-861-8872
Practice Address - Fax:303-399-1081
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04191223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics