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General NPI Number Information
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NPI Number | 1205931193
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Entity Type | Individual
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Provider Name | SANDA M. MOLDOVAN DDS
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Gender | Female
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 08/26/2009
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Provider Practice Location Address
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Address Line | 23504 LYONS AVE STE 104
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City | SANTA CLARITA
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State | CA
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Zip | 91321-2530
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Country | US
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Telephone | 661-254-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 465 N ROXBURY DR STE 701
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4210
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Country | US
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Telephone | 323-839-9676
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Fax | 323-656-1544
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 51361
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License Number State | CA
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