Provider Demographics
NPI:1477714426
Name:EVERSHED, MORGAN PAUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:PAUL
Last Name:EVERSHED
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 1:1718 PASEO SAN LUIS
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-4610
Mailing Address - Country:US
Mailing Address - Phone:520-458-1835
Mailing Address - Fax:
Practice Address - Street 1:1718 PASEO SAN LUIS
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-4610
Practice Address - Country:US
Practice Address - Phone:520-458-1835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4823179-99211223P0221X
AZD0081511223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry