Provider Demographics
NPI:1689128845
Name:MORA, CLARA GRACE (DDS)
Entity Type:Individual
Prefix:
First Name:CLARA
Middle Name:GRACE
Last Name:MORA
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 1:2780 STATE ST STE 11
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-5528
Mailing Address - Country:US
Mailing Address - Phone:805-770-8280
Mailing Address - Fax:
Practice Address - Street 1:2780 STATE ST STE 11
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-5528
Practice Address - Country:US
Practice Address - Phone:805-770-8280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-05
Last Update Date:2021-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100594122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist