Provider Demographics
NPI:1871217950
Name:SILGUERO RUBIO, MARY DANIELA (DMD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:DANIELA
Last Name:SILGUERO RUBIO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 WINTHROP AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-4289
Mailing Address - Country:US
Mailing Address - Phone:978-794-0040
Mailing Address - Fax:
Practice Address - Street 1:964 GLENWAY DR STE A
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-9204
Practice Address - Country:US
Practice Address - Phone:704-252-5793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC135281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty