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General NPI Number Information
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NPI Number | 1457807687
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Entity Type | Organization
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Legal Business Name | MOLTA & MOORE DDS PLLC
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Dates
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Enumeration Date | 08/28/2016
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Last Update Date | 08/28/2016
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Provider Practice Location Address
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Address Line | 349 EARNIE LANE
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City | HOLLY SPRINGS
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State | NC
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Zip | 27540
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Country | US
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Telephone | 919-825-3131
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Fax |
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Provider Business Mailing Address
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Address Line | 349 EARNIE LANE
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City | HOLLY SPRINGS
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State | NC
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Zip | 27540
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Country | US
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Telephone | 919-825-3131
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Fax |
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Authorized Official
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Title or Position | OWNER/GENERAL DENTIST
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Name | DR. DIANA CAROLINA MOLTA MOORE
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Credential | DDS
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Telephone | 919-825-3131
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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 | 10065
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 10155
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License Number State | NC
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