Individual
ANA R MORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1633 S ALAMEDA ST, COMPTON, CA 90220-4976
(310) 627-5600
Mailing address
517 N ACACIA AVE, COMPTON, CA 90220-2228
(310) 904-2634
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
57847
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NA
—
CA
Enumeration date
08/17/2020
Last updated
08/17/2020
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