Provider Demographics
NPI:1013095421
Name:DILLOW, MORGAN CHASE (DMD)
Entity Type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:CHASE
Last Name:DILLOW
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2517 SIR BARTON WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2275
Mailing Address - Country:US
Mailing Address - Phone:859-543-2456
Mailing Address - Fax:859-543-2373
Practice Address - Street 1:2517 SIR BARTON WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2275
Practice Address - Country:US
Practice Address - Phone:859-543-2456
Practice Address - Fax:859-543-2373
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY81161223P0221X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY60004041Medicaid