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General NPI Number Information
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NPI Number | 1255846879
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Entity Type | Individual
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Provider Name | MORGAN ELIZABETH CALLARI RDH
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Gender | Female
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Dates
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Enumeration Date | 12/05/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 10205 S RIVA RIDGE LOOP
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City | FORT DRUM
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State | NY
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Zip | 13602
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Country | US
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Telephone | 315-772-8891
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Fax |
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Provider Business Mailing Address
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Address Line | 94405A TIMBERLINE DR
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City | FORT DRUM
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State | NY
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Zip | 13603-3264
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Country | US
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Telephone | 770-548-2297
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH043071
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License Number State | GA
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