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Organization
EDITH MORA DMD, INC.
Active
Organization
EDITH MORA DMD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDITH IVONNE MORA D.M.D (DENTIST)
(209) 462-2452
Entity
Organization
Contact information
Practice address
3133 W MARCH LN STE 1080, STOCKTON, CA 95219-2360
(209) 951-4304
Mailing address
3133 W MARCH LN STE 1080, STOCKTON, CA 95219-2360
(209) 951-4304
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
53470
CA
1223G0001X
General Practice Dentistry
Primary
58214
CA
Other
Enumeration date
12/29/2014
Last updated
12/02/2015
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