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General NPI Number Information
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NPI Number | 1194983049
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Entity Type | Organization
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Legal Business Name | MARIA ESTELA MORA DDS INC
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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 | 1051 W 29TH ST STE 4
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City | HIALEAH
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State | FL
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Zip | 33012-5057
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Country | US
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Telephone | 305-887-0387
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Fax | 305-887-2089
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Provider Business Mailing Address
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Address Line | 1051 W 29TH ST STE 4
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City | HIALEAH
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State | FL
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Zip | 33012-5057
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Country | US
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Telephone | 305-887-0387
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Fax | 305-887-2089
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARIA E MORA
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Credential |
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Telephone | 305-887-0387
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN-0012758
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License Number State | FL
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