Provider Demographics
NPI:1881740280
Name:AYALA, RODRIGO (DDS)
Entity type:Individual
Prefix:
First Name:RODRIGO
Middle Name:
Last Name:AYALA
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 1:1625 SOUTH H ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304
Mailing Address - Country:US
Mailing Address - Phone:661-398-1744
Mailing Address - Fax:661-398-8017
Practice Address - Street 1:1625 SOUTH H ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304
Practice Address - Country:US
Practice Address - Phone:661-398-1744
Practice Address - Fax:661-398-8017
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50726122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist