Provider Demographics
NPI:1952491102
Name:GARRISON, RAYMOND SLOAN JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:SLOAN
Last Name:GARRISON
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:608 LANKASHIRE RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-5428
Mailing Address - Country:US
Mailing Address - Phone:336-768-4170
Mailing Address - Fax:336-716-9045
Practice Address - Street 1:131 MILLER ST
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-2508
Practice Address - Country:US
Practice Address - Phone:336-716-4353
Practice Address - Fax:336-716-9045
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC35491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice