Provider Demographics
NPI:1669560140
Name:RAY A. DAIL, D.D.S., P.C.
Entity type:Organization
Organization Name:RAY A. DAIL, D.D.S., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PERIODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAIL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-872-7777
Mailing Address - Street 1:716 DENBIGH BLVD
Mailing Address - Street 2:SUITE A 4
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608-4414
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:716 DENBIGH BLVD
Practice Address - Street 2:SUITE A 4
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23608-4414
Practice Address - Country:US
Practice Address - Phone:757-872-7777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010043991223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty