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General NPI Number Information
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NPI Number | 1245110360
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Entity Type | Organization
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Legal Business Name | SANDRA LUZ MORA HOLGUIN
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Dates
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Enumeration Date | 09/08/2025
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | AV. DE LAS AMERICAS 411 L-10
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City | JUAREZ
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State | CHIH, MEXICO
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Zip | 32310
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Country | MX
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Telephone |
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Fax |
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Provider Business Mailing Address
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Address Line | 6101 GATEWAY BLVD W SPC 625 PMB 529 PMB 529
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City | EL PASO
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State | TX
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Zip | 79925
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST OWNER
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Name | MRS. SANDRA LUZ MORA
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Credential |
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Telephone | 656-359-0367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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