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General NPI Number Information
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NPI Number | 1720153489
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Entity Type | Individual
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Provider Name | TIMOTHY J MORGAN D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 03/17/2011
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Provider Practice Location Address
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Address Line | 3011 MAINE ST SUITE 2
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City | QUINCY
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State | IL
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Zip | 62301-4400
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Country | US
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Telephone | 217-223-7846
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Fax |
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Provider Business Mailing Address
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Address Line | 3011 MAINE ST SUITE 2
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City | QUINCY
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State | IL
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Zip | 62301-4400
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Country | US
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Telephone | 217-223-7846
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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 | 019-017107
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License Number State | IL
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