Provider Demographics
NPI:1215093844
Name:MORGAN, DEBRA LONG (DMD)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:LONG
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 1:9609 EAST VISTA DRIVE
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:MO
Mailing Address - Zip Code:63050
Mailing Address - Country:US
Mailing Address - Phone:636-797-9090
Mailing Address - Fax:
Practice Address - Street 1:20 WEST JOHNSON STREET
Practice Address - Street 2:
Practice Address - City:BONNE TERRE
Practice Address - State:MO
Practice Address - Zip Code:63628
Practice Address - Country:US
Practice Address - Phone:573-358-7566
Practice Address - Fax:573-358-1736
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000160655122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist