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General NPI Number Information
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NPI Number | 1316156839
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Entity Type | Individual
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Provider Name | CAROLINE PIMENTEL MOORE D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3110 E PLAZA BLVD
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City | NATIONAL CITY
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State | CA
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Zip | 91950-3932
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Country | US
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Telephone | 619-479-5533
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Fax | 619-470-6260
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Provider Business Mailing Address
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Address Line | 3110 E PLAZA BLVD
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City | NATIONAL CITY
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State | CA
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Zip | 91950-3932
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Country | US
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Telephone | 619-479-5533
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Fax | 619-470-6260
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 44951
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License Number State | CA
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