Provider Demographics
NPI:1316232713
Name:MORALES, LAURA I (DMD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:I
Last Name:MORALES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:33 CALLE RESOLUCION
Mailing Address - Street 2:SUITE 800
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920-2706
Mailing Address - Country:US
Mailing Address - Phone:787-603-5170
Mailing Address - Fax:787-622-0555
Practice Address - Street 1:33 CALLE RESOLUCION
Practice Address - Street 2:SUITE 800
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-2706
Practice Address - Country:US
Practice Address - Phone:787-603-5170
Practice Address - Fax:787-622-0555
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR28561223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics