Provider Demographics
NPI:1194972877
Name:MORGAN, ISAAC JOHN (DMD)
Entity type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:JOHN
Last Name:MORGAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3415 5TH ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-7365
Mailing Address - Country:US
Mailing Address - Phone:605-348-6818
Mailing Address - Fax:605-348-4690
Practice Address - Street 1:3415 5TH ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-7365
Practice Address - Country:US
Practice Address - Phone:605-348-6818
Practice Address - Fax:605-348-4690
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDD09771223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery