Provider Demographics
NPI:1114031283
Name:MORALES, OLGA ANASTASIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:OLGA
Middle Name:ANASTASIA
Last Name:MORALES
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 1:4138 DYER ST STE 3
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-3975
Mailing Address - Country:US
Mailing Address - Phone:510-487-4800
Mailing Address - Fax:510-487-4802
Practice Address - Street 1:4138 DYER ST STE 3
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-3975
Practice Address - Country:US
Practice Address - Phone:510-487-4800
Practice Address - Fax:510-487-4802
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA408601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice