Provider Demographics
NPI:1215202742
Name:MONTE D. MORGAN D.M.D., P.C.
Entity Type:Organization
Organization Name:MONTE D. MORGAN D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MONTE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-362-7869
Mailing Address - Street 1:160 RAMSGATE SQ S
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-5876
Mailing Address - Country:US
Mailing Address - Phone:503-362-7869
Mailing Address - Fax:503-362-5034
Practice Address - Street 1:160 RAMSGATE SQ S
Practice Address - Street 2:SUITE 150
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-5876
Practice Address - Country:US
Practice Address - Phone:503-362-7869
Practice Address - Fax:503-362-5034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-16
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6503122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty