Provider Demographics
NPI:1013038447
Name:MORGAN AND MORIO ORAL AND MAXILLOFACIAL SURGERY
Entity Type:Organization
Organization Name:MORGAN AND MORIO ORAL AND MAXILLOFACIAL SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMINIC
Authorized Official - Middle Name:G
Authorized Official - Last Name:MORIO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:319-743-0077
Mailing Address - Street 1:1395 BOYSON RD
Mailing Address - Street 2:
Mailing Address - City:HIAWATHA
Mailing Address - State:IA
Mailing Address - Zip Code:52233-2210
Mailing Address - Country:US
Mailing Address - Phone:319-743-0077
Mailing Address - Fax:319-743-0102
Practice Address - Street 1:1395 BOYSON RD
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:IA
Practice Address - Zip Code:52233-2210
Practice Address - Country:US
Practice Address - Phone:319-743-0077
Practice Address - Fax:319-743-0102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA083821223S0112X
IA081161223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0492462Medicaid
IA2468819Medicaid
IA2468819Medicaid
IAV10259Medicare UPIN