Individual
DR. SERGIO MAURICIO MOELLER ZEVALLOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
2509 S STATE ST, ANN ARBOR, MI 48104-6145
(734) 662-7874
(734) 662-1518
Mailing address
2509 S STATE ST, ANN ARBOR, MI 48104-6145
(734) 662-7874
(734) 662-1518
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2901018235
MI
1223G0001X
General Practice Dentistry
2901018235
MI
1223P0700X
Prosthodontics
Primary
2901018235
MI
Other
Enumeration date
09/13/2007
Last updated
12/01/2016
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