Individual
DR. PHILLIP MARTIN RAY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3603 INDIANA AVE, FORT CAMPBELL, KY 42223-5803
(270) 798-3675
Mailing address
874 GLENRAVEN DR, CLARKSVILLE, TN 37043-8279
(678) 995-2281
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11620
TN
Other
Enumeration date
07/05/2021
Last updated
03/24/2023
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