Provider Demographics
NPI:1922232248
Name:MORTON, AQUANETTE A (DENTAL HYGIENIST)
Entity Type:Individual
Prefix:
First Name:AQUANETTE
Middle Name:A
Last Name:MORTON
Suffix:
Gender:F
Credentials:DENTAL HYGIENIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5275 WINNESTE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45232-1130
Mailing Address - Country:US
Mailing Address - Phone:513-242-1033
Mailing Address - Fax:513-242-1539
Practice Address - Street 1:5275 WINNESTE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45232-1130
Practice Address - Country:US
Practice Address - Phone:513-242-1033
Practice Address - Fax:513-242-1539
Is Sole Proprietor?:No
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH31.012656124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist