Individual
MARK SHALLAL-AYZIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1098 OLD DENTAL BUILDING, CAMPUS BOX 7450, CHAPEL HILL, NC 27599-0001
(248) 835-5343
Mailing address
724 N HERITAGE CIR, CHAPEL HILL, NC 27516-4203
(248) 835-5343
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
151001
NC
Other
Enumeration date
07/08/2014
Last updated
07/08/2014
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