Provider Demographics
NPI:1295457182
Name:RICHARD A RAY DDS PC
Entity type:Organization
Organization Name:RICHARD A RAY DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:313-291-6000
Mailing Address - Street 1:22387 ECORSE RD
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-1860
Mailing Address - Country:US
Mailing Address - Phone:313-291-6000
Mailing Address - Fax:313-291-9681
Practice Address - Street 1:22387 ECORSE RD
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-1860
Practice Address - Country:US
Practice Address - Phone:313-291-6000
Practice Address - Fax:313-291-9681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental