Provider Demographics
NPI:1972113322
Name:RAY GARNER DDS PC
Entity type:Organization
Organization Name:RAY GARNER DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARNER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-782-9269
Mailing Address - Street 1:365 E LOMOND VIEW DR
Mailing Address - Street 2:
Mailing Address - City:NORTH OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84414-2269
Mailing Address - Country:US
Mailing Address - Phone:801-782-9269
Mailing Address - Fax:801-605-3590
Practice Address - Street 1:365 E LOMOND VIEW DR
Practice Address - Street 2:
Practice Address - City:NORTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84414-2269
Practice Address - Country:US
Practice Address - Phone:801-782-9269
Practice Address - Fax:801-605-3590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-31
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty