Organization
RONALD D. GAITROS, DDS, MS, PA
Active
Organization
RONALD D. GAITROS, DDS, MS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD D. GAITROS DDS, MS (OFFICER/DIRECTOR)
(910) 762-2618
Entity
Organization
Contact information
Practice address
1122 MEDICAL CENTER DR, WILMINGTON, NC 28401-7305
(910) 762-2618
(910) 763-5173
Mailing address
1122 MEDICAL CENTER DR, WILMINGTON, NC 28401-7305
(910) 762-2618
(910) 763-5173
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5707
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
145233
GUARDIAN
NC
01
—
733616
UCCI
NC
05
—
8993034
—
NC
01
—
93034
BCBS
NC
Enumeration date
04/01/2008
Last updated
04/24/2009
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