Provider Demographics
NPI:1205840329
Name:MORTON, LEO DON (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEO
Middle Name:DON
Last Name:MORTON
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 1:1215 LAUREL AVE
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-4781
Mailing Address - Country:US
Mailing Address - Phone:847-945-9411
Mailing Address - Fax:
Practice Address - Street 1:9101 N GREENWOOD AVE
Practice Address - Street 2:SUITE 308
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-1499
Practice Address - Country:US
Practice Address - Phone:847-299-1095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist
Not Answered1223P0221XDental ProvidersDentistPediatric Dentistry