Provider Demographics
NPI:1376692517
Name:MCMORRAN, DAVID FLAVIO (DMD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:FLAVIO
Last Name:MCMORRAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 EAST CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-4621
Mailing Address - Country:US
Mailing Address - Phone:508-655-4747
Mailing Address - Fax:
Practice Address - Street 1:48 EAST CENTRAL ST
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-4621
Practice Address - Country:US
Practice Address - Phone:508-655-4747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11349122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist