| NPI | 1619449774 |
|---|---|
| Former Legal Business Name | EVERARDO MORA |
| Entity Type | Organization |
| Authorized Contact | EVERARDO MORA Dentist 619-488-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2018-12-28 |
| Last Update Date | 2018-12-28 |