MEDICARE: TIFFANY MORALES DREW DDS

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	122300000X	Dentist	30970	TX

General Provider Information

NPI Number	:	1811379449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY MORALES DREW DDS

Provider Business Mailing Address
First Line	:	2180 TARTAN TRL
Second Line	:
City	:	HIGHLAND VILLAGE
State	:	TX
Zip	:	75077-3154
Country	:	US
Telephone Number	:	787-412-9585
Fax Number	:

Provider Business Practice Location Address
First Line	:	2180 TARTAN TRL
Second Line	:
City	:	HIGHLAND VILLAGE
State	:	TX
Zip	:	75077-3154
Country	:	US
Telephone Number	:	787-412-9585
Fax Number	:

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

Provider Enumeration Date	:	06/19/2015
Last Update Date	:	06/19/2015

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