Provider Demographics
NPI:1225727597
Name:PHILLIPS, MORGAN LEIGH (DMD)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:LEIGH
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 W W T HARRIS BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-8522
Mailing Address - Country:US
Mailing Address - Phone:704-427-0277
Mailing Address - Fax:
Practice Address - Street 1:1525 W W T HARRIS BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-8522
Practice Address - Country:US
Practice Address - Phone:704-427-0277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-03
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13305122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist