Provider Demographics
NPI:1225100688
Name:MORGAN, JOHN DANIEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DANIEL
Last Name:MORGAN
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 1:118 W COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:75840-3120
Mailing Address - Country:US
Mailing Address - Phone:903-389-2232
Mailing Address - Fax:903-389-5092
Practice Address - Street 1:118 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:TX
Practice Address - Zip Code:75840-3120
Practice Address - Country:US
Practice Address - Phone:903-389-2232
Practice Address - Fax:903-389-5092
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX146721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice