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Individual

MARIA CHANG MORAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S

Contact information

Practice address
10104 FORD AVE, SUITE G, RICHMOND HILL, GA 31324-8850
(912) 445-5337
(888) 289-4301
Mailing address
12 IRON GATE CT, POOLER, GA 31322-9677
(804) 519-4147

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0401413604
VA
1223G0001X
General Practice Dentistry
DGD.8297 GD
SC
1223G0001X
General Practice Dentistry
Primary
DN014874
GA

Other

Enumeration date
09/30/2013
Last updated
11/17/2014
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