=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306407358
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MORGAN LEE BARNES DMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/20/2019
-----------------------------------------------------
Last Update Date | 06/20/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 105 S RAILROAD ST
-----------------------------------------------------
City | BENSON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27504-1325
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-628-4744
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 609 W MAIN ST
-----------------------------------------------------
City | BENSON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27504-1353
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-524-0469
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 11386
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------