Provider Demographics
NPI:1053716324
Name:MCCRAY, EARNEST L (RDH, BS)
Entity type:Individual
Prefix:MR
First Name:EARNEST
Middle Name:L
Last Name:MCCRAY
Suffix:
Gender:M
Credentials:RDH, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2927 HIGH PLAINS DR
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-5759
Mailing Address - Country:US
Mailing Address - Phone:910-884-7984
Mailing Address - Fax:
Practice Address - Street 1:2927 HIGH PLAINS DR
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-5759
Practice Address - Country:US
Practice Address - Phone:910-884-7984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
247000000X
NC7890124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
No247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health Information