Provider Demographics
NPI:1801458047
Name:DE OLIVEIRA-MORA, PAULA CRISTINA
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:CRISTINA
Last Name:DE OLIVEIRA-MORA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8921 IMMOKALEE RD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-3933
Mailing Address - Country:US
Mailing Address - Phone:239-330-4940
Mailing Address - Fax:
Practice Address - Street 1:8921 IMMOKALEE RD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34120-3933
Practice Address - Country:US
Practice Address - Phone:239-330-4940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN24390122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist