Provider Demographics
NPI:1336396639
Name:JASPER, MICHELE MORESCHI (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:MORESCHI
Last Name:JASPER
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 1:2752 PLEASANT RD.
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708
Mailing Address - Country:US
Mailing Address - Phone:803-548-4351
Mailing Address - Fax:803-548-4353
Practice Address - Street 1:2752 PLEASANT RD.
Practice Address - Street 2:SUITE 106
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708
Practice Address - Country:US
Practice Address - Phone:803-548-4351
Practice Address - Fax:803-548-4353
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3004122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist