Healthcare Provider Details

I. General information

NPI: 1467658161
Provider Name (Legal Business Name): RICK MORANT DMD MS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1358 BOSTON POST RD SUITE 2
OLD SAYBROOK CT
06475
US

IV. Provider business mailing address

1358 BOSTON POST RD SUITE 2
OLD SAYBROOK CT
06475
US

V. Phone/Fax

Practice location:
  • Phone: 860-388-3522
  • Fax: 860-388-3526
Mailing address:
  • Phone: 860-388-3522
  • Fax: 860-388-3526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberCT008924
License Number StateCT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. RICARDO D MORANT
Title or Position: MEMBER
Credential:
Phone: 860-388-3522