Healthcare Provider Details

I. General information

NPI: 1912772666
Provider Name (Legal Business Name): MORGAN DUKE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2023
Last Update Date: 11/21/2023
Certification Date: 11/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 BANNOCK ST
DENVER CO
80204-4506
US

IV. Provider business mailing address

12201 6 1/2 MILE RD
BATTLE CREEK MI
49014-9535
US

V. Phone/Fax

Practice location:
  • Phone: 303-602-8200
  • Fax:
Mailing address:
  • Phone: 269-209-4356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number002026894
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: