Provider Demographics
NPI:1275799777
Name:MORIARTY, JEANNE MARIE (DMD)
Entity Type:Individual
Prefix:DR
First Name:JEANNE
Middle Name:MARIE
Last Name:MORIARTY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 N SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1905
Mailing Address - Country:US
Mailing Address - Phone:201-825-8550
Mailing Address - Fax:201-825-8788
Practice Address - Street 1:14 N SPRUCE ST
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1905
Practice Address - Country:US
Practice Address - Phone:201-825-8550
Practice Address - Fax:201-825-8788
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DIO1722800122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist