Provider Demographics
NPI:1063783215
Name:MORGAN, TIFFANY (DMD)
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 COMMERCE DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:FT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-2714
Mailing Address - Country:US
Mailing Address - Phone:215-550-7186
Mailing Address - Fax:215-646-6166
Practice Address - Street 1:301 E CITY AVE
Practice Address - Street 2:SUTIE G5
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1708
Practice Address - Country:US
Practice Address - Phone:610-660-9510
Practice Address - Fax:215-646-6166
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-19
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS038919122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist