Provider Demographics
NPI:1184824567
Name:RODRIGO AYALA DDS INC.
Entity Type:Organization
Organization Name:RODRIGO AYALA DDS INC.
Other - Org Name:RODRIGO AYALA DDS INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RODRIGO
Authorized Official - Middle Name:
Authorized Official - Last Name:AYALA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:661-398-1744
Mailing Address - Street 1:1625 S H ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304-4931
Mailing Address - Country:US
Mailing Address - Phone:661-398-1744
Mailing Address - Fax:661-398-8017
Practice Address - Street 1:1625 S H ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-4931
Practice Address - Country:US
Practice Address - Phone:661-398-1744
Practice Address - Fax:661-398-8017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA507261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty