Provider Demographics
NPI:1740242494
Name:MORGAN COUNTY DENTAL CARE PC
Entity Type:Organization
Organization Name:MORGAN COUNTY DENTAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MONTY
Authorized Official - Middle Name:C
Authorized Official - Last Name:KINGSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:970-842-2494
Mailing Address - Street 1:242 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BRUSH
Mailing Address - State:CO
Mailing Address - Zip Code:80723
Mailing Address - Country:US
Mailing Address - Phone:970-842-2494
Mailing Address - Fax:970-842-5217
Practice Address - Street 1:242 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:BRUSH
Practice Address - State:CO
Practice Address - Zip Code:80723
Practice Address - Country:US
Practice Address - Phone:970-842-2494
Practice Address - Fax:970-842-5217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7376122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty