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Individual
DR. RONALD DALE GAITROS
Active
Individual
DR. RONALD DALE GAITROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
5707
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8993034
—
NC
01
—
93034
BLUE CROSS BLUE SHIELD #
NC
Enumeration date
10/10/2005
Last updated
01/07/2011
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