Provider Demographics
NPI:1437179298
Name:MOLDOVAN, DORINA (DDS)
Entity Type:Individual
Prefix:
First Name:DORINA
Middle Name:
Last Name:MOLDOVAN
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 1:901 SE 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BCH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-5611
Mailing Address - Country:US
Mailing Address - Phone:954-426-2298
Mailing Address - Fax:954-574-0805
Practice Address - Street 1:901 SE 8TH AVE
Practice Address - Street 2:
Practice Address - City:DEERFIELD BCH
Practice Address - State:FL
Practice Address - Zip Code:33441-5611
Practice Address - Country:US
Practice Address - Phone:954-426-2298
Practice Address - Fax:954-574-0805
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLD146281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice