Provider Demographics
NPI:1760598684
Name:MCLAUGHLIN, RAY H (DMD)
Entity Type:Individual
Prefix:DR
First Name:RAY
Middle Name:H
Last Name:MCLAUGHLIN
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 1:249 S PAINTER AVE
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:AL
Mailing Address - Zip Code:36360-0865
Mailing Address - Country:US
Mailing Address - Phone:334-774-7556
Mailing Address - Fax:334-774-5459
Practice Address - Street 1:249 S PAINTER AVE
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AL
Practice Address - Zip Code:36360-0865
Practice Address - Country:US
Practice Address - Phone:334-774-7556
Practice Address - Fax:334-774-5459
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL36021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL785467OtherUNITED CONCORDIA
AL510 94567OtherBCBS