Provider Demographics
NPI:1699740936
Name:DAY, MARY MORAN (DDS)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:MORAN
Last Name:DAY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 159
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-0159
Mailing Address - Country:US
Mailing Address - Phone:252-222-3333
Mailing Address - Fax:866-846-5876
Practice Address - Street 1:217 PROFESSIONAL CIR
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4303
Practice Address - Country:US
Practice Address - Phone:252-222-3333
Practice Address - Fax:866-846-5876
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC71541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1808771OtherUNITED CONCORDIA/TRICARE
NC9025EOtherBLUE CROSS BLUE SHIELD