Provider Demographics
NPI:1043668445
Name:AESTHETIC & IMPLANT DENTISTRY
Entity Type:Organization
Organization Name:AESTHETIC & IMPLANT DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVIS
Authorized Official - Middle Name:W
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-723-5544
Mailing Address - Street 1:102 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-3212
Mailing Address - Country:US
Mailing Address - Phone:972-723-5544
Mailing Address - Fax:
Practice Address - Street 1:102 S 7TH ST
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-3212
Practice Address - Country:US
Practice Address - Phone:972-723-5544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-26
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental