Provider Demographics
NPI:1326196163
Name:CABRERA, MOISES (DDS)
Entity Type:Individual
Prefix:DR
First Name:MOISES
Middle Name:
Last Name:CABRERA
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 1:101 E 50TH PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1446
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:305-557-1745
Practice Address - Street 1:14609 SW 104TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-2905
Practice Address - Country:US
Practice Address - Phone:305-388-3725
Practice Address - Fax:305-388-1748
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 15114122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist