Provider Demographics
NPI:1003266719
Name:MILLAN-MORALES, ALICIA MARGARITA (DMD)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:MARGARITA
Last Name:MILLAN-MORALES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 E BAY DR STE 206
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-2438
Mailing Address - Country:US
Mailing Address - Phone:727-532-2312
Mailing Address - Fax:
Practice Address - Street 1:2700 E BAY DR STE 206
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-2438
Practice Address - Country:US
Practice Address - Phone:727-532-2312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2019-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 21913122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist