Provider Demographics
NPI:1649526278
Name:DOOLEY, MORGAN ASHLEY EMERY (DDS)
Entity type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:ASHLEY EMERY
Last Name:DOOLEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MORGAN
Other - Middle Name:ASHLEY
Other - Last Name:EMERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2800 COLLEGE AVE BLDG 263
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-4700
Mailing Address - Country:US
Mailing Address - Phone:618-474-7000
Mailing Address - Fax:
Practice Address - Street 1:2800 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-4742
Practice Address - Country:US
Practice Address - Phone:618-474-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-01
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20120165311223G0001X
IL0190290971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL019029097OtherLICENSE
MO2012016531OtherLICENSE