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Individual
DR. ERIC J MAYUGA
Active
Individual
DR. ERIC J MAYUGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7031
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23931023
BCBS OF KC
MO
01
—
383059
BCBS OF KS
KS
Enumeration date
08/07/2007
Last updated
08/07/2007
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