Provider Demographics
NPI:1467658161
Name:RICK MORANT DMD MS LLC
Entity Type:Organization
Organization Name:RICK MORANT DMD MS LLC
Other - Org Name:RICK MORANT DMD MS ENDODONTICS LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:D
Authorized Official - Last Name:MORANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-388-3522
Mailing Address - Street 1:1358 BOSTON POST RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:OLD SAYBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06475
Mailing Address - Country:US
Mailing Address - Phone:860-388-3522
Mailing Address - Fax:860-388-3526
Practice Address - Street 1:1358 BOSTON POST RD
Practice Address - Street 2:SUITE 2
Practice Address - City:OLD SAYBROOK
Practice Address - State:CT
Practice Address - Zip Code:06475
Practice Address - Country:US
Practice Address - Phone:860-388-3522
Practice Address - Fax:860-388-3526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT0089241223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty