Provider Demographics
NPI:1457582496
Name:MORELLI, JAMES R (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:MORELLI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:20673 SW ROY ROGERS RD
Mailing Address - Street 2:STE 201
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-9222
Mailing Address - Country:US
Mailing Address - Phone:503-925-0588
Mailing Address - Fax:503-925-0418
Practice Address - Street 1:20673 SW ROY ROGERS RD
Practice Address - Street 2:STE 201
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-9222
Practice Address - Country:US
Practice Address - Phone:503-925-0588
Practice Address - Fax:503-925-0418
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD93301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice