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Individual

EDDIE MORALES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
2933 W LAYTON AVE, GREENFIELD, WI 53221-2626
(414) 282-2642
Mailing address
2933 W LAYTON AVE, GREENFIELD, WI 53221-2626
(414) 282-2642

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
7160-15
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ENROLLED
MN
Enumeration date
06/23/2010
Last updated
11/05/2013
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