Provider Demographics
NPI:1831350917
Name:MORGAN DENTAL CARE
Entity type:Organization
Organization Name:MORGAN DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:207-839-2655
Mailing Address - Street 1:94 MAIN ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:GORHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04038-1340
Mailing Address - Country:US
Mailing Address - Phone:207-839-2655
Mailing Address - Fax:207-839-5828
Practice Address - Street 1:94 MAIN ST
Practice Address - Street 2:UNIT 1
Practice Address - City:GORHAM
Practice Address - State:ME
Practice Address - Zip Code:04038-1340
Practice Address - Country:US
Practice Address - Phone:207-839-2655
Practice Address - Fax:207-839-5828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME2235122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty