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General NPI Number Information
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NPI Number | 1306056874
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Entity Type | Individual
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Provider Name | ROGER MORTON DDS
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Gender | Male
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6959 ARAPAHO RD 595
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City | DALLAS
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State | TX
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Zip | 75248-4022
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Country | US
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Telephone | 972-960-0082
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Fax |
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Provider Business Mailing Address
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Address Line | 11792 HIGHWAY 205
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City | LAVON
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State | TX
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Zip | 75166
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Country | US
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Telephone | 972-771-2953
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 21143
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License Number State | TX
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