Provider Demographics
NPI:1245360544
Name:DORROUGH, RAYMOND L (DDS)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:L
Last Name:DORROUGH
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 1:3105 RAILROAD AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-5252
Mailing Address - Country:US
Mailing Address - Phone:925-432-8509
Mailing Address - Fax:925-432-8357
Practice Address - Street 1:3105 RAILROAD AVE
Practice Address - Street 2:SUITE D
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-5252
Practice Address - Country:US
Practice Address - Phone:925-432-8509
Practice Address - Fax:925-432-8357
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA267521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice