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General NPI Number Information
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NPI Number | 1972760338
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Entity Type | Individual
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Provider Name | DEISY MON MORALES D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 01/22/2010
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Provider Practice Location Address
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Address Line | 11912 VALLEY BLVD SUITE A
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City | EL MONTE
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State | CA
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Zip | 91732-3153
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Country | US
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Telephone | 626-442-6500
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Fax | 626-442-6502
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Provider Business Mailing Address
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Address Line | 11912 VALLEY BLVD STE. A
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City | EL MONTE
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State | CA
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Zip | 91732-3153
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Country | US
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Telephone | 626-442-6500
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Fax | 626-442-6502
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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 | 55819
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License Number State | CA
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