MEDICARE: DR. JOSEPH EDWARD MORNEAU D.D.S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	5341	LA
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	28942	TX

General Provider Information

NPI Number	:	1124003827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH EDWARD MORNEAU D.D.S

Provider Business Mailing Address
First Line	:	964 VIA VANNUCCI WAY
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89011-0106
Country	:	US
Telephone Number	:	619-578-1405
Fax Number	:

Provider Business Practice Location Address
First Line	:	6910 N MESA ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-4445
Country	:	US
Telephone Number	:	844-477-9441
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	01/25/2018

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