Provider Demographics
NPI:1184782625
Name:MOROCO MALONEY, JACQUELINE RENEE (DDS)
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:RENEE
Last Name:MOROCO MALONEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 LINTON BLVD
Mailing Address - Street 2:SUITE D 505
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445
Mailing Address - Country:US
Mailing Address - Phone:561-638-9963
Mailing Address - Fax:561-638-9968
Practice Address - Street 1:4800 LINTON BLVD
Practice Address - Street 2:SUITE D 505
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445
Practice Address - Country:US
Practice Address - Phone:561-638-9963
Practice Address - Fax:561-638-9968
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028802L1223G0001X
FLDN133321223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223G0001XDental ProvidersDentistGeneral Practice
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics