Provider Demographics
NPI:1770780009
Name:VERONICA D. RAY, DDS, PC
Entity type:Organization
Organization Name:VERONICA D. RAY, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:D
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:970-206-0045
Mailing Address - Street 1:1136 E STUART ST
Mailing Address - Street 2:#3120
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-1195
Mailing Address - Country:US
Mailing Address - Phone:970-206-0045
Mailing Address - Fax:970-206-0107
Practice Address - Street 1:1136 E STUART ST
Practice Address - Street 2:#3120
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-1195
Practice Address - Country:US
Practice Address - Phone:970-206-0045
Practice Address - Fax:970-206-0107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8864122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1962490607OtherNPI - INDIVIDUAL