Provider Demographics
NPI:1457404675
Name:MORETTON, TOD R (DDS)
Entity Type:Individual
Prefix:DR
First Name:TOD
Middle Name:R
Last Name:MORETTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10078 LANTERN RD
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-9685
Mailing Address - Country:US
Mailing Address - Phone:317-570-9000
Mailing Address - Fax:317-577-9911
Practice Address - Street 1:10078 LANTERN RD
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-9685
Practice Address - Country:US
Practice Address - Phone:317-570-9000
Practice Address - Fax:317-577-9911
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120096781223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics