Provider Demographics
NPI:1629260021
Name:LARRY J MORAY, DDS, MS PLLC VI
Entity Type:Organization
Organization Name:LARRY J MORAY, DDS, MS PLLC VI
Other - Org Name:BRIER CREEK ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MORAY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-225-6255
Mailing Address - Street 1:PO BOX 2625
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27515-2625
Mailing Address - Country:US
Mailing Address - Phone:919-225-6255
Mailing Address - Fax:
Practice Address - Street 1:10411 MONCREIFFE RD
Practice Address - Street 2:AUITE 105A
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-7819
Practice Address - Country:US
Practice Address - Phone:919-544-5700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC59341223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty