Provider Demographics
NPI:1770503781
Name:RAY, DONALD W II (DMD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:W
Last Name:RAY
Suffix:II
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 1:432 FRYE FARM RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-6480
Mailing Address - Country:US
Mailing Address - Phone:724-537-0800
Mailing Address - Fax:724-537-0904
Practice Address - Street 1:432 FRYE FARM RD
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-6480
Practice Address - Country:US
Practice Address - Phone:724-537-0800
Practice Address - Fax:724-537-0904
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027383-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA619983OtherUNITED CONCORDIA PROVIDER