Provider Demographics
NPI:1578942025
Name:MORGAN, BROOKS TYGH (DDS)
Entity Type:Individual
Prefix:DR
First Name:BROOKS
Middle Name:TYGH
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 1:18632 BEACH BLVD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-2045
Mailing Address - Country:US
Mailing Address - Phone:714-636-9700
Mailing Address - Fax:
Practice Address - Street 1:18632 BEACH BLVD
Practice Address - Street 2:SUITE 115
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-2045
Practice Address - Country:US
Practice Address - Phone:714-636-9700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34388122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist