MEDICARE: DR. CHRISTIAN GABRIEL MORALES-OLIVER 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	390200000X	Student in an Organized Health Care Education/Training Program
2	1223G0001X	General Practice Dentistry	3521	PR

General Provider Information

NPI Number	:	1578293601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTIAN GABRIEL MORALES-OLIVER DMD

Provider Business Mailing Address
First Line	:	501 AVE SAGRADO CORAZON APT 6B
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00915-3322
Country	:	US
Telephone Number	:	787-363-0334
Fax Number	:

Provider Business Practice Location Address
First Line	:	551 AVE ESCORIAL
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00920-4706
Country	:	US
Telephone Number	:	787-782-0403
Fax Number	:

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

Provider Enumeration Date	:	06/13/2022
Last Update Date	:	08/21/2024

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