Provider Demographics
NPI:1396740569
Name:STAFFEL, MORNA CHRISTIAN (DDS)
Entity type:Individual
Prefix:DR
First Name:MORNA
Middle Name:CHRISTIAN
Last Name:STAFFEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2921 LACKLAND RD
Mailing Address - Street 2:STE 201
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-4173
Mailing Address - Country:US
Mailing Address - Phone:817-732-2821
Mailing Address - Fax:817-463-0419
Practice Address - Street 1:2921 LACKLAND RD
Practice Address - Street 2:STE 201
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-4173
Practice Address - Country:US
Practice Address - Phone:817-732-2821
Practice Address - Fax:817-463-0419
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX182771223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry