Rosa M Mora, D.D.S.

Individual provider Active NPI General Practice Dentistry · Alton, TX

NPI 1700965258 · NPPES record last updated Nov 1, 2013

Key facts

NPI
1700965258
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
20419 (TX)
Practice address
921 E Main Avenue Suite #2
Alton, TX 78573
Phone
(956) 583-5050
Fax
(956) 583-5067
NPI assigned
Nov 3, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
20419TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
HJC Home Health Care Services, Inc. Past
since Jan 16, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 20419 TX
General Practice Dentistry 1223G0001X 20419 TX Yes

Addresses

Primary practice location

921 E Main Avenue Suite #2
Alton, TX 78573

Mailing address

921 E Main Avenue Suite #2
Alton, TX 78573
Phone (956) 583-5050

Other providers in Alton, TX

All providers in Alton, TX · General Practice Dentistry in Texas

Sources for this page

Verify at the official NPI Registry.