Provider Demographics
NPI:1174781538
Name:LUIS F MOTA DMD MS PA
Entity type:Organization
Organization Name:LUIS F MOTA DMD MS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:F
Authorized Official - Last Name:MOTA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-945-0909
Mailing Address - Street 1:3031 NE 163RD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4462
Mailing Address - Country:US
Mailing Address - Phone:305-945-0909
Mailing Address - Fax:
Practice Address - Street 1:3031 NE 163RD ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4462
Practice Address - Country:US
Practice Address - Phone:305-945-0909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-01
Last Update Date:2008-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN158471223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty