Provider Demographics
NPI:1790941623
Name:RAYAS, LOUIS G (DDS)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:G
Last Name:RAYAS
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 1:1710 MEMORIAL DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-5700
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1710 MEMORIAL DR
Practice Address - Street 2:SUITE B
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-5700
Practice Address - Country:US
Practice Address - Phone:831-637-5882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA309751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice