Provider Demographics
NPI:1649317033
Name:MORGAN, RAY H JR (DMD)
Entity type:Individual
Prefix:DR
First Name:RAY
Middle Name:H
Last Name:MORGAN
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:120 N MEDICAL PKWY
Mailing Address - Street 2:BUILDING 200, SUITE 100
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-7062
Mailing Address - Country:US
Mailing Address - Phone:770-591-7979
Mailing Address - Fax:770-591-3365
Practice Address - Street 1:120 N MEDICAL PKWY
Practice Address - Street 2:BUILDING 200, SUITE 100
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-7062
Practice Address - Country:US
Practice Address - Phone:770-591-7979
Practice Address - Fax:770-591-3365
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA105041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice