Provider Demographics
NPI:1588647549
Name:MORALES, RICARDO RUBEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:RUBEN
Last Name:MORALES
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 1:4138 DYER ST
Mailing Address - Street 2:SUITE 3
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
Practice Address - Street 2:SUITE 3
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?:Not Answered
Enumeration Date:2005-11-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA421881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice