Healthcare Provider Details

I. General information

NPI: 1366424434
Provider Name (Legal Business Name): ARTHUR LAMAR MORGAN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/15/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 N JEFFERSON ST
PERRY FL
32347-2653
US

IV. Provider business mailing address

313 N JEFFERSON ST
PERRY FL
32347-2653
US

V. Phone/Fax

Practice location:
  • Phone: 850-584-2674
  • Fax: 850-584-2738
Mailing address:
  • Phone: 850-584-2674
  • Fax: 850-584-2738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN8938
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: