Provider Demographics
NPI:1124147434
Name:YRAY, RIZALINO O JR (DDS)
Entity type:Individual
Prefix:DR
First Name:RIZALINO
Middle Name:O
Last Name:YRAY
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W SADD STREET
Mailing Address - Street 2:
Mailing Address - City:NORTH PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53153-0404
Mailing Address - Country:US
Mailing Address - Phone:262-392-2244
Mailing Address - Fax:262-510-2441
Practice Address - Street 1:205 W SADD ST
Practice Address - Street 2:
Practice Address - City:NORTH PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53153
Practice Address - Country:US
Practice Address - Phone:262-392-2244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI44620151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice