Colclasure, Ray E

Colclasure, Ray E is an sole proprietor health care provider with primary practice located at 550 W 46Th Ave , Pine Bluff AR 71603-7134. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Colclasure, Ray E can be contacted via phone (870) 536-4567.

Contact Information

Primary practice address
550 W 46Th Ave Pine Bluff AR 71603-7134
Fax: (870) 536-3580
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 2047 Arkansas

Profile Details

NPI number 1962420067
LBN Legal business name Colclasure, Ray E
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 17th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962420067 NPPES
Arkansas Other 98892 UNITED CONCORDIA PROVIDER
Arkansas Other 58101 UNITED CONCORDIA PROVIDER

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