Provider Demographics
NPI:1558493601
Name:MORETTI, JOY STEPHANIE (DDS)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:STEPHANIE
Last Name:MORETTI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 158
Mailing Address - Street 2:1009 CROWDER DRIVE
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-0158
Mailing Address - Country:US
Mailing Address - Phone:804-794-8745
Mailing Address - Fax:804-794-3568
Practice Address - Street 1:1009 CROWDER DR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-4237
Practice Address - Country:US
Practice Address - Phone:804-794-8745
Practice Address - Fax:804-794-3568
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA82721223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics