Provider Demographics
NPI:1508877069
Name:MORGAN, JAIMEE A (DOS)
Entity Type:Individual
Prefix:DR
First Name:JAIMEE
Middle Name:A
Last Name:MORGAN
Suffix:
Gender:F
Credentials:DOS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 E FT UNION BLVD
Mailing Address - Street 2:#102
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047
Mailing Address - Country:US
Mailing Address - Phone:801-561-9999
Mailing Address - Fax:801-561-9979
Practice Address - Street 1:204 E FT UNION BLVD
Practice Address - Street 2:#102
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047
Practice Address - Country:US
Practice Address - Phone:801-561-9999
Practice Address - Fax:801-561-9979
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3432881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice