Provider Demographics
NPI:1992050918
Name:BALL, MORGAN TYLER (DMD)
Entity type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:TYLER
Last Name:BALL
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 1:2501 N PEARL ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-2540
Mailing Address - Country:US
Mailing Address - Phone:253-752-6349
Mailing Address - Fax:
Practice Address - Street 1:2501 N PEARL ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-2540
Practice Address - Country:US
Practice Address - Phone:253-752-6349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE602903551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice