Provider Demographics
NPI:1447335492
Name:MOORE, MARIA J (DDS)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:J
Last Name:MOORE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 W FREMONT AVE
Mailing Address - Street 2:SUITE U3
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-3021
Mailing Address - Country:US
Mailing Address - Phone:408-739-1111
Mailing Address - Fax:408-739-1133
Practice Address - Street 1:990 W FREMONT AVE
Practice Address - Street 2:SUITE U3
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-3021
Practice Address - Country:US
Practice Address - Phone:408-739-1111
Practice Address - Fax:408-739-1133
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0366831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice