Provider Demographics
NPI:1649288770
Name:MCCRAY, ROY HOWARD (DDS)
Entity type:Individual
Prefix:DR
First Name:ROY
Middle Name:HOWARD
Last Name:MCCRAY
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 1:2510 PULASKI PIKE NW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35810-3746
Mailing Address - Country:US
Mailing Address - Phone:256-852-6954
Mailing Address - Fax:256-852-6969
Practice Address - Street 1:2510 PULASKI PIKE NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35810-3746
Practice Address - Country:US
Practice Address - Phone:256-852-6954
Practice Address - Fax:256-852-6969
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALCS 34411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51094492OtherBLUE CROSS BLUE SHIELD AL