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General NPI Number Information
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NPI Number | 1093973927
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Entity Type | Individual
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Provider Name | JOY LEA MOELLER RDH, COM
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Gender | Female
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Dates
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Enumeration Date | 05/28/2008
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Last Update Date | 05/28/2008
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Provider Practice Location Address
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Address Line | 15340 ALBRIGHT ST UNIT 305 910 VIA DE LA PAZ #106
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City | PACIFIC PALISADES
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State | CA
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Zip | 90272-2528
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Country | US
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Telephone | 310-454-4044
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Fax | 310-454-0391
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Provider Business Mailing Address
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Address Line | 15340 ALBRIGHT ST UNIT 305
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City | PACIFIC PALISADES
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State | CA
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Zip | 90272-2528
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Country | US
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Telephone | 310-454-4044
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Fax | 310-454-0391
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 8267
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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