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General NPI Number Information
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NPI Number | 1942061502
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Entity Type | Individual
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Provider Name | GIRANDY PATRICIA MORENO DMD
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Gender | Female
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Dates
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Enumeration Date | 01/22/2024
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 124 NEWBURY ST
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City | PEABODY
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State | MA
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Zip | 01960-4066
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Country | US
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Telephone | 978-278-5478
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Fax |
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Provider Business Mailing Address
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Address Line | 124 NEWBURY ST
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City | PEABODY
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State | MA
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Zip | 01960-4066
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Country | US
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Telephone | 407-222-6657
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN10000793
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License Number State | MA
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