MEDICARE: DORINA MOLDOVAN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	D14628	FL

General Provider Information

NPI Number	:	1437179298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DORINA MOLDOVAN DDS

Provider Business Mailing Address
First Line	:	901 SE 8TH AVE
Second Line	:
City	:	DEERFIELD BCH
State	:	FL
Zip	:	33441-5611
Country	:	US
Telephone Number	:	954-426-2298
Fax Number	:	954-574-0805

Provider Business Practice Location Address
First Line	:	901 SE 8TH AVE
Second Line	:
City	:	DEERFIELD BCH
State	:	FL
Zip	:	33441-5611
Country	:	US
Telephone Number	:	954-426-2298
Fax Number	:	954-574-0805

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	07/08/2007

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