Provider Demographics
NPI:1457741860
Name:JOSEPH MORNEAU DDS INC
Entity Type:Organization
Organization Name:JOSEPH MORNEAU DDS INC
Other - Org Name:ORTHODONTICS OF SAN MARCOS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MORNEAU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-578-1405
Mailing Address - Street 1:955 BOARDWALK
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-2659
Mailing Address - Country:US
Mailing Address - Phone:619-578-1405
Mailing Address - Fax:
Practice Address - Street 1:955 BOARDWALK
Practice Address - Street 2:SUITE 202
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-2659
Practice Address - Country:US
Practice Address - Phone:619-578-1405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-23
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA610441223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty