Provider Demographics
NPI:1891515730
Name:MORTON, JOSEPH THOMAS NATHANIEL (DDS)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:THOMAS NATHANIEL
Last Name:MORTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15010 STRATUS LOOP APT 108
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-7903
Mailing Address - Country:US
Mailing Address - Phone:512-636-5760
Mailing Address - Fax:
Practice Address - Street 1:873 GOOD HOMES RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-6628
Practice Address - Country:US
Practice Address - Phone:407-723-0060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN29458122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist