Provider Demographics
NPI:1619618014
Name:MARIE A. MOECKEL, DDS INC
Entity Type:Organization
Organization Name:MARIE A. MOECKEL, DDS INC
Other - Org Name:MARIE A. MOECKEL, DDS INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOECKEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-846-3551
Mailing Address - Street 1:8899 UNIVERSITY CENTER LN STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-1009
Mailing Address - Country:US
Mailing Address - Phone:858-452-1504
Mailing Address - Fax:
Practice Address - Street 1:8899 UNIVERSITY CENTER LN STE 110
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-1009
Practice Address - Country:US
Practice Address - Phone:858-452-1504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-07
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental