MEDICARE: DR. JOSE A. MORALES-MORALES DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	00843	PR

General Provider Information

NPI Number	:	1205806684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE A. MORALES-MORALES DMD

Provider Business Mailing Address
First Line	:	PO BOX 29736
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00929-0736
Country	:	US
Telephone Number	:	787-755-4347
Fax Number	:	787-283-7440

Provider Business Practice Location Address
First Line	:	65 INFANTERIA AVE. CONCORDIA SHOPPING CTR.
Second Line	:	570 CALLE NAPOLES SUITE 208
City	:	RIO PIEDRAS
State	:	PR
Zip	:	00924-4605
Country	:	US
Telephone Number	:	787-755-4347
Fax Number	:	787-283-7440

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. JOSE A. MORALES-MORALES DMD” Practice Location

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