Organization
MIDDLE PENINSULA ORAL AND FACIAL SURGERY LLC
Active
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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