MEDICARE: EMILIO ESTEBAN LANDUCCI MORILLO RDH

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	124Q00000X	Dental Hygienist	DH045510	GA

General Provider Information

NPI Number	:	1366276438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILIO ESTEBAN LANDUCCI MORILLO RDH

Provider Business Mailing Address
First Line	:	3228 CALDWELL RD NE
Second Line	:
City	:	BROOKHAVEN
State	:	GA
Zip	:	30319-2920
Country	:	US
Telephone Number	:	646-496-7630
Fax Number	:

Provider Business Practice Location Address
First Line	:	3369 BUFORD HWY NE STE 840
Second Line	:
City	:	BROOKHAVEN
State	:	GA
Zip	:	30329-1742
Country	:	US
Telephone Number	:	404-636-5570
Fax Number	:

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

Provider Enumeration Date	:	08/29/2024
Last Update Date	:	01/09/2026

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Directions to “ EMILIO ESTEBAN LANDUCCI MORILLO RDH” Practice Location

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