Healthcare Provider Details

I. General information

NPI: 1427281963
Provider Name (Legal Business Name): SUJEY MORGAN D.D.S., MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2009
Last Update Date: 10/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 KNEELAND ST DHS1247
BOSTON MA
02111-1527
US

IV. Provider business mailing address

1 KNEELAND ST DHS 1247
BOSTON MA
02111-1527
US

V. Phone/Fax

Practice location:
  • Phone: 970-389-0625
  • Fax:
Mailing address:
  • Phone: 970-389-0625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDF 11217
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License NumberDF11217
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: