Provider Demographics
NPI:1497180889
Name:MORNINGSTAR, BRIAN SAMUEL (DDS)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:SAMUEL
Last Name:MORNINGSTAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 DOVER CENTER RD
Mailing Address - Street 2:
Mailing Address - City:BAY VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44140-2376
Mailing Address - Country:US
Mailing Address - Phone:440-899-7950
Mailing Address - Fax:440-899-0124
Practice Address - Street 1:660 DOVER CENTER RD
Practice Address - Street 2:
Practice Address - City:BAY VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44140-2376
Practice Address - Country:US
Practice Address - Phone:330-899-7950
Practice Address - Fax:440-899-0124
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.023939122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist