Individual
DR. AMANDA LYNN MORELLATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
UMMC SCHOOL OF DENTISTRY, 2500 NORTH STATE STREET, JACKSON, MS 39216
(601) 573-4367
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
PRV-TP-116-19
MS
Other
Enumeration date
09/18/2019
Last updated
02/17/2020
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