1033952080 NPI number — DR. SABRINA CRISTINA MONTIEL MORALES DMD

Table of content: DR. SABRINA CRISTINA MONTIEL MORALES DMD (NPI 1033952080)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033952080 NPI number — DR. SABRINA CRISTINA MONTIEL MORALES DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MONTIEL MORALES
Provider First Name:
SABRINA
Provider Middle Name:
CRISTINA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033952080
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/17/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2146 PASA VERDE LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33327-2201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
770-624-0550
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
473 ALFRED ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BIDDEFORD
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04005-9465
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-283-3775
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/17/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  DEN5156 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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