Provider Demographics
NPI:1043412315
Name:MOROZOVA, YULIYA VADIMOVNA (DMD)
Entity Type:Individual
Prefix:
First Name:YULIYA
Middle Name:VADIMOVNA
Last Name:MOROZOVA
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 1:4585 MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-2603
Mailing Address - Country:US
Mailing Address - Phone:415-584-8500
Mailing Address - Fax:
Practice Address - Street 1:4585 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-2603
Practice Address - Country:US
Practice Address - Phone:415-584-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45928122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist