Provider Demographics
NPI:1346434875
Name:LUIS MOYA DDS, INC.
Entity Type:Organization
Organization Name:LUIS MOYA DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOYA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-341-3009
Mailing Address - Street 1:36943 COOK ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-6076
Mailing Address - Country:US
Mailing Address - Phone:760-341-3009
Mailing Address - Fax:760-341-3070
Practice Address - Street 1:36943 COOK ST
Practice Address - Street 2:SUITE 101
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-6076
Practice Address - Country:US
Practice Address - Phone:760-341-3009
Practice Address - Fax:760-341-3070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty