Provider Demographics
NPI:1922303049
Name:DAIL, RAY A (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAY
Middle Name:A
Last Name:DAIL
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 1:716 DENBIGH BLVD
Mailing Address - Street 2:SUITE A4
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608-4414
Mailing Address - Country:US
Mailing Address - Phone:757-872-7777
Mailing Address - Fax:757-877-4295
Practice Address - Street 1:716 DENBIGH BLVD
Practice Address - Street 2:SUITE A4
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23608-4414
Practice Address - Country:US
Practice Address - Phone:757-872-7777
Practice Address - Fax:757-877-4295
Is Sole Proprietor?:No
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010043991223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics