Provider Demographics
NPI:1760487490
Name:MORALES, JESUS M (DMD)
Entity Type:Individual
Prefix:DR
First Name:JESUS
Middle Name:M
Last Name:MORALES
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:CALLE 2 S.O. CAPARRA TERRACE
Mailing Address - Street 2:#1567
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-1402
Mailing Address - Country:US
Mailing Address - Phone:787-449-8500
Mailing Address - Fax:
Practice Address - Street 1:654 AVE. SAN PATRICIO
Practice Address - Street 2:URB. SUMMIT HILLS RIO PIEDRAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920
Practice Address - Country:US
Practice Address - Phone:787-792-6266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-17
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice