Healthcare Provider Details

I. General information

NPI: 1942370077
Provider Name (Legal Business Name): E ORLANDO MORANTES DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3321 NO BUFFALO DR SUITE 107
LAS VEGAS NV
89129
US

IV. Provider business mailing address

3321 NO BUFFALO DR SUITE 107
LAS VEGAS NV
89129
US

V. Phone/Fax

Practice location:
  • Phone: 702-794-0820
  • Fax: 702-794-0961
Mailing address:
  • Phone: 702-794-0820
  • Fax: 702-794-0961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberNV2394
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: