Provider Demographics
NPI:1962504639
Name:PURCELL, REX RAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:REX
Middle Name:RAY
Last Name:PURCELL
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 1:9713 MIRANDA DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-7667
Mailing Address - Country:US
Mailing Address - Phone:919-848-8197
Mailing Address - Fax:
Practice Address - Street 1:2840 PLAZA PL
Practice Address - Street 2:SUITE 110
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-6346
Practice Address - Country:US
Practice Address - Phone:919-787-8060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC68651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice