Moreno Dental Group, Pdc

LBN: Moreno Dental Group, Pdc
Moreno Dental Group, Pdc is an health care organization with primary practice located at 3427 Deer Park Dr Suite #C, Stockton CA 95219-2355. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Periodontics. Dental Providers / Dentist is the primary health care specialty. Moreno Dental Group, Pdc can be contacted via phone (209) 478-3036, or through Moreno, Janice Gale via phone (209) 478-3036.

Contact Information

Primary practice address
3427 Deer Park Dr Suite #C Stockton CA 95219-2355
Phone: (209) 478-3036
Fax: (209) 478-0258
Website:
Map and Directions
Authorized official contact:
Name: Moreno, Janice Gale Doctor of Dental Surgery (DDS)
Phone: (209) 478-3036

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 34387 California
Dental Providers / Dentist 122300000X 54645 California
Dental Providers / Periodontics 1223P0300X 32491 California

Profile Details

NPI number 1790866309
LBN Legal business name Moreno Dental Group, Pdc
DBA Doing business as
Authorized official Moreno, Janice Gale Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 18th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790866309 NPPES
California Other 1860612 STATE CORPORATION NUMBER
California Other 33195579 STATE CORPORATION NUMBER

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