Healthcare Provider Details

I. General information

NPI: 1710802558
Provider Name (Legal Business Name): EMILY MORETTI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 BOARDMAN CANFIELD RD STE R
BOARDMAN OH
44512-4361
US

IV. Provider business mailing address

725 BOARDMAN CANFIELD RD STE R
BOARDMAN OH
44512-4361
US

V. Phone/Fax

Practice location:
  • Phone: 330-726-8886
  • Fax: 330-726-8887
Mailing address:
  • Phone: 330-726-8886
  • Fax: 330-726-8887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number31.016342
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: