Provider Demographics
NPI:1831222173
Name:MORGAN, CHARLIE J II (DDS)
Entity type:Individual
Prefix:DR
First Name:CHARLIE
Middle Name:J
Last Name:MORGAN
Suffix:II
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7236 CROSSWATER STE 200
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-0759
Mailing Address - Country:US
Mailing Address - Phone:903-266-9260
Mailing Address - Fax:903-213-9644
Practice Address - Street 1:7236 CROSSWATER STE 200
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-0759
Practice Address - Country:US
Practice Address - Phone:903-266-9260
Practice Address - Fax:903-213-9644
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16861122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist