| Doctor Name: | DR. MARGHERITA GRAZIOSA DE MOYA |
| NPI Number: | 1043238165 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DDS |
| License Number: | DN11639 |
| Business Practice Address: | 403 Hollywood Blvd Nw Suite A101 Fort Walton Beach, FL - 325484502 |
| Business Phone Number: | 8508643131 |
| Business Fax Number: | 8508645115 |
| Mailing Address: | 403 Hollywood Blvd Nw, Suite A101 FORT WALTON BEACH |
| State: | FL |
| Postal Code: | 325484502 |
| Phone Number: | 8508643131 |
| Fax Number: | 8508645115 |
| NPI Enumeration Date: | 07/17/2006 |
| NPI Last Update Date: | 12/13/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223P0221X |
| License Number: | DN11639 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Dentist |
| Taxonomy Specialization: | Pediatric Dentistry |
| Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |