Provider Demographics
NPI:1457463572
Name:JONNA J MORESCHI DMD PC
Entity Type:Organization
Organization Name:JONNA J MORESCHI DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JONNA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MORESCHI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:803-548-4445
Mailing Address - Street 1:1021 MAXWELL MILL ROAD
Mailing Address - Street 2:SUITE #E
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708
Mailing Address - Country:US
Mailing Address - Phone:803-548-4445
Mailing Address - Fax:803-548-5566
Practice Address - Street 1:1021 MAXWELL MILL ROAD
Practice Address - Street 2:SUITE #E
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708
Practice Address - Country:US
Practice Address - Phone:803-548-4445
Practice Address - Fax:803-548-5566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial PathologyGroup - Single Specialty