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General NPI Number Information
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NPI Number | 1013024991
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Entity Type | Individual
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Provider Name | JOHN M MORALES DDS
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Gender | Male
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4429 S RIVER BLVD SUITE D
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City | INDEPENDENCE
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State | MO
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Zip | 64055-4658
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Country | US
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Telephone | 816-373-0200
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Fax | 816-373-0581
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Provider Business Mailing Address
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Address Line | 4429 S RIVER BLVD SUITE D
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City | INDEPENDENCE
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State | MO
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Zip | 64055-4658
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Country | US
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Telephone | 816-373-0200
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Fax | 816-373-0581
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 12359
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License Number State | MO
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