| Luis Moran Dds A Dental Corporation | |
|
8682 Beach Blvd Suite #102 Buena Park CA 90620-4808 | |
| (714) 484-9050 | |
| (714) 484-9060 |
| Full Name | Luis Moran Dds A Dental Corporation |
|---|---|
| Speciality | Dentist |
| Location | 8682 Beach Blvd, Buena Park, California |
| Authorized Official Name and Position | Luis Moran (PRESIDENT) |
| Authorized Official Contact | 7144849050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Luis Moran Dds A Dental Corporation 8682 Beach Blvd Suite #102 Buena Park CA 90620-4808 Ph: (714) 484-9050 | Luis Moran Dds A Dental Corporation 8682 Beach Blvd Suite #102 Buena Park CA 90620-4808 Ph: (714) 484-9050 |
| NPI Number | 1174835888 |
|---|---|
| Provider Enumeration Date | 07/10/2010 |
| Last Update Date | 10/16/2017 |
| Medicare PECOS PAC ID | 1951656917 |
|---|---|
| Medicare Enrollment ID | O20180614001418 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174835888 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 45150 (California) | Primary |
| Provider Name | Luis E Moran |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1649397530 PECOS PAC ID: 0749535706 Enrollment ID: I20180614001582 |
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