Provider Demographics
NPI:1942374962
Name:TIMOTHY J. MORGAN, D.D.S., P.C.
Entity Type:Organization
Organization Name:TIMOTHY J. MORGAN, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:217-223-7846
Mailing Address - Street 1:3011 MAINE ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62301-4400
Mailing Address - Country:US
Mailing Address - Phone:217-223-7846
Mailing Address - Fax:
Practice Address - Street 1:3011 MAINE ST
Practice Address - Street 2:SUITE 2
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62301-4400
Practice Address - Country:US
Practice Address - Phone:217-223-7846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190171071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty