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General NPI Number Information
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NPI Number | 1245758085
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Entity Type | Individual
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Provider Name | ERNESTO FELIX MORALES DENTIST (IN MEXICO)
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Gender | Male
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Dates
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Enumeration Date | 08/31/2017
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Last Update Date | 08/31/2017
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Provider Practice Location Address
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Address Line | CALLE PRIMERA #253 COL. JARDIN
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City | MATAMOROS
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State | TAMAULIPAS
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Zip | 87330
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Country | MX
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Telephone | 956-455-1432
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Fax |
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Provider Business Mailing Address
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Address Line | 125 CANDLEWICK CT
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City | BROWNSVILLE
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State | TX
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Zip | 78521
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Country | US
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Telephone | 956-455-1432
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Fax | 868-813-3107
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 1886762
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License Number State | ZZ
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