Healthcare Provider Details

I. General information

NPI: 1720901697
Provider Name (Legal Business Name): MORGAN PAIGE POGALZ DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4635 GULFSTARR DR STE 200
DESTIN FL
32541-0742
US

IV. Provider business mailing address

90 ALBATROSS CT
SANTA ROSA BEACH FL
32459-8516
US

V. Phone/Fax

Practice location:
  • Phone: 850-654-9584
  • Fax:
Mailing address:
  • Phone: 950-616-8723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN32299
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: