Provider Demographics
NPI:1912019001
Name:MORESCHI, JONNA J (DMD)
Entity Type:Individual
Prefix:MS
First Name:JONNA
Middle Name:J
Last Name:MORESCHI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC35150505OS204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery