Healthcare Provider Details

I. General information

NPI: 1255431227
Provider Name (Legal Business Name): STEVEN M MORGANO DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BOSTON UNIVERSITY DENTAL SCHOOL 100 EAST NEWTON STREET
BOSTON MA
02118
US

IV. Provider business mailing address

572 EAST BROADWAY UNIT 1
SOUTH BOSOTN MA
02127
US

V. Phone/Fax

Practice location:
  • Phone: 617-638-5429
  • Fax:
Mailing address:
  • Phone: 617-269-3552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number13326
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: