Provider Demographics
NPI:1568573327
Name:MORARASU, GEORGE M (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:M
Last Name:MORARASU
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 1:620 S DORA ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-5466
Mailing Address - Country:US
Mailing Address - Phone:651-253-8550
Mailing Address - Fax:
Practice Address - Street 1:620 S DORA ST
Practice Address - Street 2:SUITE 202
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-5466
Practice Address - Country:US
Practice Address - Phone:651-253-8550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN118401223G0001X
CA582221223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN540037600Medicaid