MEDICARE: DR. MERCEDES AYBAR-DIAZ DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	7247	NC

General Provider Information

NPI Number	:	1679659619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MERCEDES AYBAR-DIAZ DDS

Provider Business Mailing Address
First Line	:	6308 FALLS OF NEUSE RD
Second Line	:	SUITE 400
City	:	RALEIGH
State	:	NC
Zip	:	27615-6807
Country	:	US
Telephone Number	:	919-431-9111
Fax Number	:	919-431-9155

Provider Business Practice Location Address
First Line	:	6308 FALLS OF NEUSE RD
Second Line	:	SUITE 400
City	:	RALEIGH
State	:	NC
Zip	:	27615-6807
Country	:	US
Telephone Number	:	919-431-9111
Fax Number	:	919-431-9155

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	07/08/2007

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