Provider Demographics
NPI:1124402011
Name:COAKLEY, MORGAN (DMD)
Entity type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:
Last Name:COAKLEY
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 1:110 FOXFORD CT
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-6508
Mailing Address - Country:US
Mailing Address - Phone:561-801-6309
Mailing Address - Fax:
Practice Address - Street 1:110 FOXFORD CT
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-6508
Practice Address - Country:US
Practice Address - Phone:561-801-6309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-10
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019030236122300000X
FLDN21292122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist