Provider Demographics
NPI:1831267749
Name:AJAYI, MICHAEL AKINTOLA (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:AKINTOLA
Last Name:AJAYI
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:3980 SAN PABLO DAM RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:EL SOBRANTE
Mailing Address - State:CA
Mailing Address - Zip Code:94803-2840
Mailing Address - Country:US
Mailing Address - Phone:510-222-2163
Mailing Address - Fax:510-222-2169
Practice Address - Street 1:3980 SAN PABLO DAM RD
Practice Address - Street 2:SUITE 102
Practice Address - City:EL SOBRANTE
Practice Address - State:CA
Practice Address - Zip Code:94803-2840
Practice Address - Country:US
Practice Address - Phone:510-222-2163
Practice Address - Fax:510-222-2169
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA425131223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery