Provider Demographics
NPI:1659416808
Name:MOREHART, DENNIS P (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:P
Last Name:MOREHART
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 1:2411 HERITAGE TRL
Mailing Address - Street 2:SUITE #4
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-1639
Mailing Address - Country:US
Mailing Address - Phone:580-237-2213
Mailing Address - Fax:580-237-2231
Practice Address - Street 1:2411 HERITAGE TRL
Practice Address - Street 2:SUITE #4
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-1639
Practice Address - Country:US
Practice Address - Phone:580-237-2213
Practice Address - Fax:580-237-2231
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK34041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice