Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 19607 | MA |
N | 1223P0300X | Periodontist | 2083 | NH |
NPI | 1053477281 |
---|---|
Provider Name | Dr. Hidetada Moroi |
First Address | Exeter, NH 03833-4848 |
Second Address | Exeter, NH 03833-4848 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2006 |
Last Update Date | 21/05/2008 |