Provider Demographics
NPI:1801927355
Name:RAYMOND GARRISON DDS PA - UDA
Entity type:Organization
Organization Name:RAYMOND GARRISON DDS PA - UDA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-549-1509
Mailing Address - Street 1:801 JONES FRANKLIN RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-3381
Mailing Address - Country:US
Mailing Address - Phone:919-852-0403
Mailing Address - Fax:919-852-0562
Practice Address - Street 1:801 JONES FRANKLIN RD
Practice Address - Street 2:SUITE 150
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-3381
Practice Address - Country:US
Practice Address - Phone:919-852-0403
Practice Address - Fax:919-852-0562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty