Organization
MIDDLE PENINSULA ORAL AND FACIAL SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MORGAN DDS (OWNER/SURGEON)
(804) 693-4220
Entity
Organization
Contact information
Practice address
7547 MEDICAL DR, GLOUCESTER, VA 23061-4351
(804) 693-4220
Mailing address
PO BOX 1056, GLOUCESTER, VA 23061-1056
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
0438000297
VA
Other
Enumeration date
02/13/2012
Last updated
02/13/2012
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