Provider Demographics
NPI:1922538149
Name:LEXINGTON DENTAL CENTER/GREGORY M MORGAN DDS, PC
Entity Type:Organization
Organization Name:LEXINGTON DENTAL CENTER/GREGORY M MORGAN DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:M
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:660-259-3381
Mailing Address - Street 1:1510 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:64067-1419
Mailing Address - Country:US
Mailing Address - Phone:660-259-3381
Mailing Address - Fax:660-259-3335
Practice Address - Street 1:1510 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MO
Practice Address - Zip Code:64067-1419
Practice Address - Country:US
Practice Address - Phone:660-259-3381
Practice Address - Fax:660-259-3335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0155981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty