Individual
HARRY J RAYBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
627 W MAIN ST, TUPELO, MS 38804-3732
(662) 840-0066
(662) 840-7966
Mailing address
627 W MAIN ST, TUPELO, MS 38804-3732
(662) 840-0066
(662) 840-7966
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
324002
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660449
—
MS
Enumeration date
05/21/2007
Last updated
07/08/2007
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