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General NPI Number Information
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NPI Number | 1326228446
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Entity Type | Organization
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Legal Business Name | LUIS MORAN DDS A DENTAL CORPORATION
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Dates
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Enumeration Date | 11/06/2007
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Last Update Date | 11/06/2007
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Provider Practice Location Address
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Address Line | 8720 GARFIELD AVE STE 104
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City | SOUTH GATE
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State | CA
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Zip | 90280-3720
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Country | US
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Telephone | 562-927-9050
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Fax | 562-927-9060
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Provider Business Mailing Address
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Address Line | 8720 GARFIELD AVE STE 104
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City | SOUTH GATE
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State | CA
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Zip | 90280-3720
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Country | US
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Telephone | 562-927-9050
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Fax | 562-927-9060
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Authorized Official
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Title or Position | OWNER
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Name | DR. LUIS MORAN
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Credential |
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Telephone | 562-927-9050
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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 | 45150
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License Number State | CA
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