Provider Demographics
NPI:1720118334
Name:RAY, DAVID ANTHOY (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ANTHOY
Last Name:RAY
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 1:205 E MOODY AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-4203
Mailing Address - Country:US
Mailing Address - Phone:865-579-9585
Mailing Address - Fax:865-579-9557
Practice Address - Street 1:205 E MOODY AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-4203
Practice Address - Country:US
Practice Address - Phone:865-579-9585
Practice Address - Fax:865-579-9557
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000019003122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist