Provider Demographics
NPI:1891838447
Name:SONIA CANTON MORAN DDS A DENTAL CORPORATION
Entity Type:Organization
Organization Name:SONIA CANTON MORAN DDS A DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:CANTON MORAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-927-9050
Mailing Address - Street 1:8720 GARFIELD AVE
Mailing Address - Street 2:SUITE # 104
Mailing Address - City:SOUTH GATE
Mailing Address - State:CA
Mailing Address - Zip Code:90280-3720
Mailing Address - Country:US
Mailing Address - Phone:562-927-9050
Mailing Address - Fax:562-927-9060
Practice Address - Street 1:8720 GARFIELD AVE
Practice Address - Street 2:SUITE # 104
Practice Address - City:SOUTH GATE
Practice Address - State:CA
Practice Address - Zip Code:90280-3720
Practice Address - Country:US
Practice Address - Phone:562-927-9050
Practice Address - Fax:562-927-9060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA450951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty