MEDICARE: DR. SAM C. MORCOS PROF DENTAL CORP

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	122300000X	Dentist

General Provider Information

NPI Number	:	1760817654
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. SAM C. MORCOS PROF DENTAL CORP

Provider Business Mailing Address
First Line	:	7271 WESTMINSTER BLVD
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-4235
Country	:	US
Telephone Number	:	714-894-3306
Fax Number	:	714-894-3023

Provider Business Practice Location Address
First Line	:	7271 WESTMINSTER BLVD
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-4235
Country	:	US
Telephone Number	:	714-894-3306
Fax Number	:	714-894-3023

Authorized Official
Title or Position	:	OWNER/DOCTOR
Name	:	DR. SAM C. MORCOS
Credential	:	DDS
Telephone Number	:	714-894-3306

Provider Enumeration Date	:	09/10/2013
Last Update Date	:	09/10/2013

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