Individual
CLARISSA MORALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
13925 LANDSTAR BLVD STE 110, ORLANDO, FL 32824-5531
(407) 270-0054
Mailing address
12748 OULTON CIR, ORLANDO, FL 32832-6126
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN17264
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200185918
PPO
—
Enumeration date
08/10/2006
Last updated
12/19/2022
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