Provider Demographics
NPI:1891854055
Name:RAY, JOSEPH PATRICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:PATRICK
Last Name:RAY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 NW LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:ADAMS
Mailing Address - State:MN
Mailing Address - Zip Code:55909
Mailing Address - Country:US
Mailing Address - Phone:507-582-3563
Mailing Address - Fax:507-582-7881
Practice Address - Street 1:407 NW LINCOLN ST
Practice Address - Street 2:
Practice Address - City:ADAMS
Practice Address - State:MN
Practice Address - Zip Code:55909
Practice Address - Country:US
Practice Address - Phone:507-582-3563
Practice Address - Fax:507-582-7881
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND10712122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist