Individual
MINERVA MARIA MORAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9033 ELMHURST AVE FL 3, JACKSON HEIGHTS, NY 11372-7935
(718) 505-6200
Mailing address
1001 SHADOW LN, LAS VEGAS, NV 89106-4124
(702) 583-2773
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
065023
NY
Other
Enumeration date
05/02/2024
Last updated
09/13/2025
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