Provider Demographics
NPI:1922214261
Name:RAY, ROBERT G (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:G
Last Name:RAY
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Gender:M
Credentials:DMD
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Mailing Address - Street 1:918 FAIRLAWN AVE
Mailing Address - Street 2:LAUREL SHOPPING CENTER
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4806
Mailing Address - Country:US
Mailing Address - Phone:301-490-6922
Mailing Address - Fax:301-490-6922
Practice Address - Street 1:918 FAIRLAWN AVE
Practice Address - Street 2:LAUREL SHOPPING CENTER
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4806
Practice Address - Country:US
Practice Address - Phone:301-490-6922
Practice Address - Fax:301-490-6922
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2021-11-30
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Provider Licenses
StateLicense IDTaxonomies
MD65161223X0400X
DCDEN28931223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics