Provider Demographics
NPI:1497949804
Name:R A MORABITO DDS PLC
Entity Type:Organization
Organization Name:R A MORABITO DDS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:MORABITO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-534-9160
Mailing Address - Street 1:6200 WILSON BLVD STE 114
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-3209
Mailing Address - Country:US
Mailing Address - Phone:703-534-9160
Mailing Address - Fax:703-237-6761
Practice Address - Street 1:6200 WILSON BLVD STE 114
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-3209
Practice Address - Country:US
Practice Address - Phone:703-534-9160
Practice Address - Fax:703-237-6761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401008893261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental