Provider Demographics
NPI:1992913628
Name:WRAY, HENRY C III (DDS)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:C
Last Name:WRAY
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 N KANSAS ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-2219
Mailing Address - Country:US
Mailing Address - Phone:703-243-6868
Mailing Address - Fax:703-243-7747
Practice Address - Street 1:920 N KANSAS ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-2219
Practice Address - Country:US
Practice Address - Phone:703-243-6868
Practice Address - Fax:703-243-7747
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010056971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice