Healthcare Provider Details

I. General information

NPI: 1205753886
Provider Name (Legal Business Name): MILDRED CAROLINA AGUILAR FAMILIA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 PARKVIEW CENTER CIR
CLAYTON NC
27520-1788
US

IV. Provider business mailing address

217 HARTSHORN CT
HOLLY SPRINGS NC
27540-6911
US

V. Phone/Fax

Practice location:
  • Phone: 984-989-6131
  • Fax:
Mailing address:
  • Phone: 910-748-6559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14855
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: