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General NPI Number Information
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NPI Number | 1104020072
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Entity Type | Organization
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Legal Business Name | MIKE MORTON DDS, PLLC
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 201 SECURITY ST
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City | KANNAPOLIS
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State | NC
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Zip | 28083-2757
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Country | US
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Telephone | 704-938-3189
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Fax | 704-938-3190
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Provider Business Mailing Address
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Address Line | 201 SECURITY ST
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City | KANNAPOLIS
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State | NC
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Zip | 28083-2757
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Country | US
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Telephone | 704-938-3189
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Fax | 704-938-3190
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. MICHAEL ANTHONY MORTON JR.
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Credential | DDS
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Telephone | 704-938-3189
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 8374
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License Number State | NC
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