Healthcare Provider Details

I. General information

NPI: 1659693653
Provider Name (Legal Business Name): MARY BURNS MORGAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2010
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MILLBURN AVE
MILLBURN NJ
07041-1940
US

IV. Provider business mailing address

34 FAIRFIELD DR
SHORT HILLS NJ
07078-1703
US

V. Phone/Fax

Practice location:
  • Phone: 973-232-5953
  • Fax: 973-619-6744
Mailing address:
  • Phone: 917-838-0026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22DI02476900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: