Individual
ANDREW RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4330 JOHNS CREEK PKWY STE 100, SUWANEE, GA 30024-6121
(770) 622-1515
Mailing address
4330 JOHNS CREEK PKWY STE 100, SUWANEE, GA 30024-6121
(770) 622-1515
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN016153
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/12/2018
Last updated
12/21/2020
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