Provider Demographics
NPI:1538153267
Name:MORELLI, ERNEST FRANCIS JR (DMD)
Entity type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:FRANCIS
Last Name:MORELLI
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5505 LA PUERTA DEL SOL BLVD S
Mailing Address - Street 2:#327
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33715-1400
Mailing Address - Country:US
Mailing Address - Phone:727-864-2137
Mailing Address - Fax:
Practice Address - Street 1:6TH DENTAL SQUADRON (AMC)
Practice Address - Street 2:8415 BAYSHORE BLVD.
Practice Address - City:MAC DILL AFB
Practice Address - State:FL
Practice Address - Zip Code:33621-1607
Practice Address - Country:US
Practice Address - Phone:813-827-9400
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI011785001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice