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Organization
MORA FAMILY DENTAL GROUP PC
Active
Organization
MORA FAMILY DENTAL GROUP PC
Active
Other names
Mora Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAUREL SANTOS D.D.S. (OFFICE MANAGER, SHAREHOLDER)
(707) 425-6216
Entity
Organization
Contact information
Practice address
1402 PENNSYLVANIA AVE, FAIRFIELD, CA 94533-3507
(707) 425-6216
(707) 425-6241
Mailing address
1402 PENNSYLVANIA AVE, FAIRFIELD, CA 94533-3507
(707) 425-6216
(707) 425-6241
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
03/16/2021
Last updated
03/16/2021
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