Healthcare Provider Details

I. General information

NPI: 1730406026
Provider Name (Legal Business Name): MORGAN FAMILY DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2010
Last Update Date: 08/01/2022
Certification Date: 08/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 BROTHERS RD
SANTA FE NM
87505
US

IV. Provider business mailing address

2201 BROTHERS RD
SANTA FE NM
87505
US

V. Phone/Fax

Practice location:
  • Phone: 505-988-4119
  • Fax: 505-988-1405
Mailing address:
  • Phone: 505-988-4119
  • Fax: 505-988-1405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDD3265
License Number StateNM

VIII. Authorized Official

Name: DR. CHRISTOPHER DAVID MORGAN
Title or Position: DENTIST/OWNER
Credential: DMD
Phone: 505-988-4119