Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 35952 | CA |
NPI | 1003224023 |
---|---|
Provider Name | Martha Elva Morett |
First Address | Del Mar, CA 92014-2810 |
Second Address | Coronado, CA 92118-1430 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2014 |
Last Update Date | 16/04/2020 |