Provider Demographics
NPI:1750895520
Name:RICARDO MORALES DDS & OLGA MORALES DDS INC
Entity type:Organization
Organization Name:RICARDO MORALES DDS & OLGA MORALES DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:RUBEN
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-487-4800
Mailing Address - Street 1:4138 DYER ST STE 3
Mailing Address - Street 2:
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 STE 3
Practice Address - Street 2:
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-30
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42188261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental