MEDICARE: DR. MARK A MORTON D.D.S.

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	1223G0001X	General Practice Dentistry	7221	KS

General Provider Information

NPI Number	:	1497764377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK A MORTON D.D.S.

Provider Business Mailing Address
First Line	:	11812 QUIVIRA RD
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66210
Country	:	US
Telephone Number	:	913-451-3400
Fax Number	:

Provider Business Practice Location Address
First Line	:	11812 QUIVIRA RD
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66210-1371
Country	:	US
Telephone Number	:	913-451-3400
Fax Number	:

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

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	07/08/2007

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