MEDICARE: DANIEL MORGAN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	56331	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	56331	OTHER	CA	STATE LICENSE

General Provider Information

NPI Number	:	1336391994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL MORGAN DDS

Provider Business Mailing Address
First Line	:	2130 HILL CT
Second Line	:
City	:	COLTON
State	:	CA
Zip	:	92324-9512
Country	:	US
Telephone Number	:	626-353-9685
Fax Number	:

Provider Business Practice Location Address
First Line	:	225 W HOSPITALITY LN STE 104
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92408-3244
Country	:	US
Telephone Number	:	909-554-3754
Fax Number	:	909-554-3752

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/15/2008
Last Update Date	:	03/17/2018

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Directions to “ DANIEL MORGAN DDS” Practice Location

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