Provider Demographics
NPI:1922265339
Name:MARITZA MORELL DMD PC
Entity Type:Organization
Organization Name:MARITZA MORELL DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARITZA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORELL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-682-3342
Mailing Address - Street 1:49 RESERVATION RD
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-3445
Mailing Address - Country:US
Mailing Address - Phone:978-682-3342
Mailing Address - Fax:978-683-9394
Practice Address - Street 1:100 AMESBURY ST
Practice Address - Street 2:SUITE 111
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1321
Practice Address - Country:US
Practice Address - Phone:978-682-3342
Practice Address - Fax:978-683-9394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA195981223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty