MEDICARE: MORGAN DENTAL SERVICES, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	3131	KY

General Provider Information

NPI Number	:	1265761415
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MORGAN DENTAL SERVICES, PLLC

Provider Business Mailing Address
First Line	:	1510 NEWTOWN PIKE
Second Line	:	SUITE 201
City	:	LEXINGTON
State	:	KY
Zip	:	40511-1251
Country	:	US
Telephone Number	:	859-233-7700
Fax Number	:	859-255-0079

Provider Business Practice Location Address
First Line	:	1510 NEWTOWN PIKE
Second Line	:	SUITE 201
City	:	LEXINGTON
State	:	KY
Zip	:	40511-1251
Country	:	US
Telephone Number	:	859-233-7700
Fax Number	:	859-255-0079

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	DR. BALLARD F MORGAN JR.
Credential	:	DMD
Telephone Number	:	859-233-7700

Provider Enumeration Date	:	12/17/2009
Last Update Date	:	12/17/2009

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