| NPI | 1356595227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAYRA K AYALA RUBIO Pediatric Dentist 336-626-7555 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 8103) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 7892) |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2008-11-05 |