Provider Demographics
NPI:1164549325
Name:TALBOT, MORRIE O (DDS)
Entity Type:Individual
Prefix:DR
First Name:MORRIE
Middle Name:O
Last Name:TALBOT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1565 S 3150 W
Mailing Address - Street 2:
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-8739
Mailing Address - Country:US
Mailing Address - Phone:480-789-2070
Mailing Address - Fax:
Practice Address - Street 1:1 GILMAN WAY
Practice Address - Street 2:#201
Practice Address - City:UNALASKA
Practice Address - State:AK
Practice Address - Zip Code:99685
Practice Address - Country:US
Practice Address - Phone:907-581-3828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT359751-9922122300000X
AK104064122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist