Organization
BSMORGAN SERVICES LLC
Active
Other names
Iconic Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDON MORGAN DDS (ORTHODONTIST / OWNER)
(410) 440-3713
Entity
Organization
Contact information
Practice address
59 GEORGIA AVE SE, ATLANTA, GA 30312-2848
(410) 440-3713
Mailing address
59 GEORGIA AVE SE, ATLANTA, GA 30312-2848
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1215312889
INDIVIDUAL NPI
GA
Enumeration date
04/28/2021
Last updated
04/28/2021
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