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General NPI Number Information
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NPI Number | 1396273025
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Entity Type | Organization
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Legal Business Name | ELIZABETH MOREJON, DMD, MS, PA
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Dates
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Enumeration Date | 05/25/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 163 TOMOKA AVE
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City | ORMOND BEACH
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State | FL
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Zip | 32174-6348
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Country | US
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Telephone | 386-672-4325
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Fax |
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Provider Business Mailing Address
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Address Line | 163 TOMOKA AVE
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City | ORMOND BEACH
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State | FL
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Zip | 32174-6348
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Country | US
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Telephone | 386-672-4325
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Fax |
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Authorized Official
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Title or Position | FINANCIAL COORDINATOR
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Name | HEATHER COLEMAN
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Credential |
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Telephone | 386-672-4325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 12420
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License Number State | FL
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