Provider Demographics
NPI:1760817654
Name:DR. SAM C. MORCOS PROF DENTAL CORP
Entity Type:Organization
Organization Name:DR. SAM C. MORCOS PROF DENTAL CORP
Other - Org Name:DR. SAM C. MORCOS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:MORCOS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-894-3306
Mailing Address - Street 1:7271 WESTMINSTER BLVD
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-4235
Mailing Address - Country:US
Mailing Address - Phone:714-894-3306
Mailing Address - Fax:714-894-3023
Practice Address - Street 1:7271 WESTMINSTER BLVD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-4235
Practice Address - Country:US
Practice Address - Phone:714-894-3306
Practice Address - Fax:714-894-3023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty