Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DN18128 | MA |
NPI | 1023546538 |
---|---|
Provider Name | Dr. Linda J Morgan |
First Address | Concord, MA 01742-1811 |
Second Address | Acton, MA 01720-3640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2017 |
Last Update Date | 28/05/2017 |