Provider Demographics
NPI:1952434441
Name:MORLEY, MARK KENT (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:KENT
Last Name:MORLEY
Suffix:
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 1:12777 VALLEY VIEW ST
Mailing Address - Street 2:SUITE #151
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92845-2507
Mailing Address - Country:US
Mailing Address - Phone:714-897-1089
Mailing Address - Fax:714-892-4492
Practice Address - Street 1:12777 VALLEY VIEW ST
Practice Address - Street 2:SUITE #151
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92845-2507
Practice Address - Country:US
Practice Address - Phone:714-897-1089
Practice Address - Fax:714-892-4492
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40281122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist