Individual
ROY E GAINES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.
Contact information
Practice address
4201 LAKE BOONE TRL, SUITE 002, RALEIGH, NC 27607-7512
(919) 787-3949
(919) 787-7634
Mailing address
4201 LAKE BOONE TRL, SUITE 002, RALEIGH, NC 27607-7512
(919) 787-3949
(919) 787-7634
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5589
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8993014
—
NC
Enumeration date
09/03/2006
Last updated
03/01/2011
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