Provider Demographics
NPI:1518035567
Name:MORAY, LAWRENCE JOEL (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:JOEL
Last Name:MORAY
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:LARRY
Other - Middle Name:J
Other - Last Name:MORAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS, MS, PA
Mailing Address - Street 1:5011 SOUTHPARK DR STE 220
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-7738
Mailing Address - Country:US
Mailing Address - Phone:919-240-7280
Mailing Address - Fax:919-240-7316
Practice Address - Street 1:1165 GREGORY DR STE A
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-6442
Practice Address - Country:US
Practice Address - Phone:252-544-5630
Practice Address - Fax:252-631-0291
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC59341223X0400X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1518035567Medicaid