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NPI Code Detail

MEDICARE: DR. MIRALDA G MORENO DDS

MEDICARE:  DR. MIRALDA G MORENO  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
1122300000XDentist60041KS

General Provider Information

NPI Number : 1982605168
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MIRALDA G MORENO DDS
Provider Business Mailing Address
First Line : 753 STATE AVE
Second Line : SUITE 375
City : KANSAS CITY
State : KS
Zip : 66101-2516
Country : US
Telephone Number : 913-647-1900
Fax Number : 913-647-1901
Provider Business Practice Location Address
First Line : 753 STATE AVE
Second Line : SUITE 375
City : KANSAS CITY
State : KS
Zip : 66101-2516
Country : US
Telephone Number : 913-647-1900
Fax Number : 913-647-1901
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2005
Last Update Date : 08/23/2011

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Directions to “ DR. MIRALDA G MORENO DDS” Practice Location

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