Individual
FELIPE MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1 LYONS ST, DEDHAM, MA 02026
(781) 329-1400
(781) 278-5667
Mailing address
PO BOX 9120, DEDHAM, MA 02027-9120
(781) 329-1400
(781) 278-5667
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
20604
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031014
NEIGHBORHOOD HEALTH PLAN
—
01
—
20604
TUFTS DELTA DENTAL
—
01
—
46037
HARVARD PILGRIM POS
—
Enumeration date
08/21/2006
Last updated
07/08/2007
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