Provider Demographics
NPI:1588641476
Name:MORGAN, RICHARD A (DDS)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
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:PO BOX 716
Mailing Address - Street 2:100 SHENANGO AVENUE
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-0716
Mailing Address - Country:US
Mailing Address - Phone:724-981-1721
Mailing Address - Fax:724-981-7025
Practice Address - Street 1:350 SHARON NEW CASTLE RD
Practice Address - Street 2:
Practice Address - City:FARRELL
Practice Address - State:PA
Practice Address - Zip Code:16121-1576
Practice Address - Country:US
Practice Address - Phone:724-981-1721
Practice Address - Fax:724-981-7025
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS019488L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2373328Medicaid
PA0017870320004Medicaid