Provider Demographics
NPI:1891990966
Name:GHAYYATH, AREF A (DMD MS)
Entity Type:Individual
Prefix:
First Name:AREF
Middle Name:A
Last Name:GHAYYATH
Suffix:
Gender:M
Credentials:DMD MS
Other - Prefix:
Other - First Name:ARAF
Other - Middle Name:A
Other - Last Name:GHAYYATH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD MS
Mailing Address - Street 1:11559 WOOD HBR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-1930
Mailing Address - Country:US
Mailing Address - Phone:210-949-1177
Mailing Address - Fax:210-949-1177
Practice Address - Street 1:7703 FLOYD CURL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3901
Practice Address - Country:US
Practice Address - Phone:210-567-3333
Practice Address - Fax:210-567-3334
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23370122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist