Individual
SAMANTHA RAE AYALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1775 E MAIN ST, COTTAGE GROVE, OR 97424-2245
(541) 649-7023
Mailing address
3319 MURRY DR, EUGENE, OR 97405-6246
(503) 881-4385
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11145
OR
Other
Enumeration date
08/27/2019
Last updated
08/27/2019
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