Healthcare Provider Details

I. General information

NPI: 1841259140
Provider Name (Legal Business Name): WILLIAM R. MORGAN DDS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 10/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 E MATTHEWS AVE SUITE 101
JONESBORO AR
72401-4315
US

IV. Provider business mailing address

1107 E MATTHEWS AVE SUITE 101
JONESBORO AR
72401-4315
US

V. Phone/Fax

Practice location:
  • Phone: 870-932-8657
  • Fax: 870-932-8671
Mailing address:
  • Phone: 870-932-8657
  • Fax: 870-932-8671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2216
License Number StateAR

VIII. Authorized Official

Name: WILLIAM RUSSELL MORGAN
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 870-932-8657