Provider Demographics
NPI:1114908183
Name:CAOILI, RAY OLIVER LLOREN (DDS)
Entity Type:Individual
Prefix:
First Name:RAY OLIVER
Middle Name:LLOREN
Last Name:CAOILI
Suffix:
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 1:5107 MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-3421
Mailing Address - Country:US
Mailing Address - Phone:415-469-7111
Mailing Address - Fax:415-469-0105
Practice Address - Street 1:5107 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-3421
Practice Address - Country:US
Practice Address - Phone:415-469-7111
Practice Address - Fax:415-469-0105
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47695122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist