Provider Demographics
NPI:1215669593
Name:MORGAN, THOMAS (DMD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
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 1:9 CENTURY LN
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02921-2606
Mailing Address - Country:US
Mailing Address - Phone:401-793-0472
Mailing Address - Fax:
Practice Address - Street 1:32 MALLETTS BAY AVE STE B
Practice Address - Street 2:
Practice Address - City:WINOOSKI
Practice Address - State:VT
Practice Address - Zip Code:05404-1960
Practice Address - Country:US
Practice Address - Phone:802-655-2385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0160134106122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist