Bradley J. Morlock, D.D.S.,P.C.
Organization Active NPI Periodontics · Lewiston, ID
NPI 1710096896 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1710096896
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Periodontics 1223P0300X
- Legal business name
- BRADLEY J. MORLOCK, D.D.S.,P.C.
- Practice address
- 3323 4TH St
Lewiston, ID 83501-4423 - Phone
- (208) 743-1114
- Fax
- (208) 743-0120
- NPI assigned
- Aug 30, 2006
- Organization subpart
- No
Authorized official
- Name
- Bradley Jay Morlock, D.D.S.
- Title
- President/Director
- Phone
- (208) 743-1114
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics |
1223P0300X | Yes |
Addresses
Primary practice location
3323 4TH St
Lewiston, ID 83501-4423
Mailing address
3323 4TH St
Lewiston, ID 83501-4423
Phone (208) 743-1114
Other providers in Lewiston, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.