Individual
MARK ALAN OGHALAI
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1405 WESTGATE CENTER DR, WINSTON-SALEM, NC 27103-2995
(336) 765-5374
(336) 760-3066
Mailing address
1405 WESTGATE CENTER DR, WINSTON-SALEM, NC 27103-2995
(336) 765-5374
(336) 760-3066
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6854
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
89902EY
BCBS
NC
05
—
89902EY
—
NC
Enumeration date
06/13/2006
Last updated
07/08/2007
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