Provider Demographics
NPI:1740325539
Name:MORELLI, ANTHONY F (DDS)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:F
Last Name:MORELLI
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 1:120 E LAKE ST
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:IL
Mailing Address - Zip Code:60101-2821
Mailing Address - Country:US
Mailing Address - Phone:630-530-2498
Mailing Address - Fax:630-530-2689
Practice Address - Street 1:120 E LAKE ST
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-2821
Practice Address - Country:US
Practice Address - Phone:630-530-2498
Practice Address - Fax:630-530-2689
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry