Blair Ray, DENTAL HYGENIST
Individual provider Active NPI Dental Hygienist · New Madrid, MO
NPI 1659711596 · NPPES record last updated Jun 25, 2013
Key facts
- NPI
- 1659711596
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 2010018542 (MO)
- Practice address
- 202B Main St
New Madrid, MO 63869-1911 - Phone
- (573) 748-5671
- Fax
- (573) 748-5317
- NPI assigned
- Jun 25, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2010018542 | MO | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Missouri Health Network | Past | Accepting new patients | |
| Southeast Missouri Health Network | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 2010018542 | MO | Yes |
Addresses
Primary practice location
202B Main St
New Madrid, MO 63869-1911
Mailing address
420 Line Street
New Madrid, MO 63869
Phone (573) 748-2404
Other providers in New Madrid, MO
- New Madrid County R-1 School District
- New Madrid Pharmacy Inc
- Pemiscot County Memorial Hospital
- Personal Touch
- Timothy P Rausch
- Elizabeth A Riley
- Utisha Robinson
- Nannette Jane Rogers Thornton
- Show-Me Grace in-Home Care Services, LLC
- Southeast Health Center of Stoddard County LLC
All providers in New Madrid, MO · Dental Hygienist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.