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General NPI Number Information
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NPI Number | 1336988385
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Entity Type | Individual
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Provider Name | NICHOLAS MORELLI DMD
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Gender | Male
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Dates
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Enumeration Date | 05/20/2024
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 362 HAWKINS PL
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City | BOONTON
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State | NJ
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Zip | 07005-1128
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Country | US
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Telephone | 973-334-9350
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Fax | 973-334-3912
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Provider Business Mailing Address
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Address Line | 107 JORDAN RD
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City | ROCKAWAY
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State | NJ
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Zip | 07866-2232
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Country | US
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Telephone | 862-209-9763
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Fax |
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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 | 22DI03033700
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License Number State | NJ
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