Provider Demographics
NPI:1861706129
Name:MOREJON, HECTOR (DMD)
Entity type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:
Last Name:MOREJON
Suffix:
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 1:2620 SW 109TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-2320
Mailing Address - Country:US
Mailing Address - Phone:786-325-7819
Mailing Address - Fax:
Practice Address - Street 1:801 NW 37TH AVE STE 204
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3882
Practice Address - Country:US
Practice Address - Phone:305-541-5556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-28
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 191621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice