Provider Demographics
NPI:1083728505
Name:MORETTA, ROBERT JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOSEPH
Last Name:MORETTA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18652 FLORIDA ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-1924
Mailing Address - Country:US
Mailing Address - Phone:714-848-4247
Mailing Address - Fax:714-848-0171
Practice Address - Street 1:18652 FLORIDA ST
Practice Address - Street 2:SUITE 300
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1924
Practice Address - Country:US
Practice Address - Phone:714-848-4247
Practice Address - Fax:714-848-0171
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA304491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice