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General NPI Number Information
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NPI Number | 1437769460
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Entity Type | Individual
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Provider Name | MORGAN ELYSSA SPICER DDS
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Gender | Female
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Dates
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Enumeration Date | 08/04/2020
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Last Update Date | 08/04/2020
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Provider Practice Location Address
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Address Line | 1825 S LAKE DR
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City | LEXINGTON
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State | SC
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Zip | 29073-7759
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Country | US
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Telephone | 803-403-8687
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Fax |
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Provider Business Mailing Address
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Address Line | 2 LONGSHOT DR
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City | CROSS HILL
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State | SC
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Zip | 29332-5775
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Country | US
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Telephone | 937-409-2007
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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 | DGD9708GD
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License Number State | SC
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