Provider Demographics
NPI:1679825459
Name:RAY, HEIDI A (DMD)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:A
Last Name:RAY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:A
Other - Last Name:RAY-MONTELEONE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:510 PELLIS RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-4583
Mailing Address - Country:US
Mailing Address - Phone:724-853-1500
Mailing Address - Fax:
Practice Address - Street 1:510 PELLIS RD
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-4583
Practice Address - Country:US
Practice Address - Phone:724-853-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-04
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027224L1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics