Provider Demographics
NPI:1508273939
Name:SHOCKEY, MORGAN (DDS)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:SHOCKEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 E US HWY 69
Mailing Address - Street 2:STE 101
Mailing Address - City:CLAYCOMO
Mailing Address - State:MO
Mailing Address - Zip Code:64119
Mailing Address - Country:US
Mailing Address - Phone:816-454-1313
Mailing Address - Fax:
Practice Address - Street 1:244 E US HWY 69
Practice Address - Street 2:STE 101
Practice Address - City:CLAYCOMO
Practice Address - State:MO
Practice Address - Zip Code:64119
Practice Address - Country:US
Practice Address - Phone:816-454-1313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014018762122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist